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Type: Journal article
Title: Endonasal dacryocystorhinostomy for nasolacrimal duct obstruction in patients with sarcoidosis
Author: Avisar, I.
McNab, A.
Dolman, P.
Patel, B.
deSousa, J.
Selva-Nayagam, D.
Malhotra, R.
Citation: Orbit, 2013; 32(4):225-230
Publisher: Taylor & Francis The Netherlands
Issue Date: 2013
ISSN: 0167-6830
Statement of
Inbal Avisar, Alan A. McNab, Peter J. Dolman, Bhupendra Patel, Jean-Louis deSousa, Dinesh Selva, and Raman Malhotra
Abstract: PURPOSE: To evaluate the outcomes of endonasal dacryocystorhinostomy (EN-DCR) surgery in patients with sarcoidosis. METHODS: Retrospective chart review of all patients with sarcoidosis undergoing EN-DCR in 6 practices from 1999-2011. RESULTS: We included 18 procedures in 14 patients (8 female, 6 male) who underwent EN-DCR for acquired NLDO secondary to sarcoidosis. The mean age was 53.7 (range 38-82). The presenting symptom in all cases was epiphora. Eight patients (57%) complained of having additional nasal congestion. Surgery was performed using endoscopic powered-type DCR with flaps in 12/18 (67%) and non-endoscopic mechanical EN-DCR in 6/18 (33%). In 15 (83%) cases the lacrimal sac and nasal mucosa appeared abnormally yellowish, crusty, oedematous and friable. Five patients were treated with pre-operative oral steroid and overall 8 patients had oral prednisolone post operatively, 30-60 mg tapered within 10 days-8 weeks. One patient had difficulties in tapering down the oral steroids at 6 months of follow-up. All patients were free of epiphora and patent to syringing, with nasal endoscopy revealing free flow of fluorescein through the ostium at a mean follow-up of 11.3 months (median follow-up 9 months). CONCLUSIONS: All 18 cases of acquired nasolacrimal duct obstruction secondary to sarcoidosis were treated successfully with EN-DCR. An abnormal appearance of the nasal mucosa is an important sign. Nasal congestion is a frequent sign. A successful outcome may not depend on intensive long-term therapy with local or systemic steroids. Mechanical or powered EN-DCR for nasolacrimal duct obstruction secondary to sarcoidosis achieves encouraging medium-term outcomes.
Keywords: Dacryocystorhinostomy; endonasal; nasolacrimal duct obstruction; sarcoidosis
Rights: © Informa Healthcare USA, Inc.
RMID: 0020130332
DOI: 10.3109/01676830.2013.788670
Appears in Collections:Opthalmology & Visual Sciences publications

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