Abstract
Purpose
To review clinical profile, management, and outcome in cases of traumatic nasolacrimal duct obstruction (NLDO).
Methods
A retrospective analysis of 28 patients with the diagnosis of traumatic NLDO during a 12-year period was done. Data regarding nature and pattern of injury, associated damage, clinical features, investigations, management, outcome, and follow-up were reviewed.
Results
Of the 28 patients reviewed in the study, 19 (68%) were male and 9 (32%) were female. Mean age of the patients was 30.1 years. The most common cause of traumatic NLDO was high-velocity blunt injury encountered in road traffic accidents (70%), and the most common pattern of injury was naso-orbito-ethmoidal fractures (64%). Traumatic telecanthus was the most commonly associated periocular injury (54%). Twenty-one patients (75%) were investigated with computed tomography–dacryocystography. A total of 26 patients were treated with external dacryocystorhinostomy with (75%) or without (18%) silicon intubation and 2 (7%) patients underwent dacryocystectomy. General anesthesia was administered in 19 (68%) patients and local anesthesia in 9 (32%) patients. Mean follow-up period was 7.71 months (range 3 months to 6 years). Successful outcome was recorded in 25 out of 26 eyes (96%) operated with external dacryocystorhinostomy with or without silicone intubation.
Conclusions
Naso-orbito-ethmoidal fracture is the main cause of traumatic NLDO, commonly in young male individuals. Telecanthus is an important presenting feature. Computed tomography–dacryocystography is a useful imaging modality in preoperative assessment and surgical planning. External dacryocystorhinostomy with or without intubation under general anesthesia gives good surgical outcome.
Get full access to this article
View all access options for this article.