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J. David Osguthorpe, MD; Thomas C. Calcaterra, MD

Arch Otolaryngol. 1979;105(5):264-266.

Abstract
• Transient nasolacrimal obstruction is a common complication of maxillary sinus, as well as rhinoplastic surgery. Permanent epiphora, however, is unusual. This communication describes 11 patients with surgical injury to the lacrimal drainage system, which necessitated dacryocystorhinostomy for correction. Seven of these cases occurred subsequent to nasoantral window procedures, three occurred after rhinoplasty, and one resulted from a partial maxillectomy. It has been shown that the two areas most vulnerable to inadvertent surgical injury are the nasolacrimal sac, located just beneath the medial canthal ligament, and the ductal ostium in the inferior meatus. We discuss the relevant anatomy of the nasolacrimal apparatus, in addition to surgical methods for avoiding injury to the system. We also describe the currently applied techniques for diagnosing and managing lacrimal obstruction and review the literature.

(Arch Otolaryngol 105:264-266, 1979)

Author Affiliations
From the Department of Surgery (Head and Neck), UCLA School of Medicine, Los Angeles. Dr Osguthorpe is now with the Medical University of South Carolina, Charleston.

Footnotes
Accepted for publication Sept 18, 1978.

Read before the 14th annual meeting of the American Academy of Facial Plastic and Reconstructive Surgery, Palm Beach, Fla, April 27, 1978.

Reprint requests to Department of Otolaryngology, Medical University of South Carolina, 171 Ashley Ave, Charleston, SC 29403 (Dr Osguthorpe).

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