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Incidence, Analysis, and Prevention

Maj William E. Bolger, MC; Col David S. Parsons, MC; Maj Eric A. Mair, MC; Frederick A. Kuhn, MD

Arch Otolaryngol Head Neck Surg. 1992;118(11):1179-1184.

Abstract
• Injury to the lacrimal drainage system with resultant epiphora is a complication of functional endoscopic sinus surgery. A study of 24 patients was conducted to determine the incidence and significance of lacrimal drainage system injuries during functional endoscopic sinus surgery. Intraoperative testing demonstrated seven occult injuries (15%) in 46 endoscopic procedures. Postoperative testing demonstrated diversion of lacrimal drainage into the middle meatus in two patients and spontaneous healing of the injured lacrimal drainage system with restoration of normal drainage in three of the patients available for follow-up testing. In no patient did epiphora develop. It is concluded that the nasolacrimal drainage system is in close proximity to the dissection cavity during functional endoscopic sinus surgery and, hence, is at risk for inadvertent injury. Occult damage to the nasolacrimal drainage system would appear to be a common event during functional endoscopic sinus surgery; however, the complication of postoperative epiphora is rare.

(Arch Otolaryngol Head Neck Surg. 1992;118:1179-1184)

Author Affiliations
USAF; USAF; USAF

From the Department of Otolaryngology Head and Neck Surgery, Wilford Hall US Air Force Medical Center, Lackland Air Force Base, Tex (Drs Bolger, Parsons, and Mair); and the Division of Otolaryngology—Head and Neck Surgery, Medical College of Georgia, Augusta (Dr Kuhn). Dr Bolger is now with the Uniformed Services University of the Health Sciences, Bethesda, Md.

Footnotes
Accepted for publication June 17, 1992.

Presented at the Annual Meeting of the American Society of Pediatric Otolaryngology, Waikoloa, Hawaii, May 11, 1991.

The opinions or assertions contained herein are the private views of the authors and are not to be construed as official or as reflecting the views of the United States Air Force or the Department of Defense.

Reprints not available.

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