Disorders of the lacrimal drainage system are, at the least, very annoying to the patient and when serious infection is present may threaten vision and life. The definitive treatment for most lacrimal drainage system is surgical.
Dacryocystorhinostomy
(DCR), a procedure that fistulizes the lacrimal sac and nasal cavity, is the most frequency lacirmal drainage surgery.
Indications for DCR include acquired nasolacrimal duct obstruction with patent canaliculi or this condition combined with a distal common canalicular obstruction, persistent nasolacrimal duct obstruction following probing and intubation, chronic
dacryocystitis, and lacrimal sac foreign bodies. The only absolute contraindication is malignancy of the lacrimal sac, which is treated by dacryocystectomy.
The patient, 55-year-old male, was admitted with the complaints of pus discharge from the medial commissure on the Rt. eye and oro-antral fistula on the Rt. maxillary sinus. In the past history, Caldwell-Luc operation was performed on the Rt.
maxilla
about 2 years before for the management of oroantral fistula. He was diagnosed as dacryocystitis with nasolacrimal duct obstruction and oro-antral fistula, and treated by dacryocystorhinostomy and Caldwell-Luc operation under general anesthesia.
The
postoperative course was unremarkable and the patient has been well for over 1 year postoperatively.
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