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Nasolacrimal evaluation and surgery.

The lacrimal drainage system is a very important functional and anatomic assembly in the orbit and midface. For surgeons who intend to become involved in its repair or reconstruction, it is mandatory to understand the full range of anatomic, physiologic, and diagnostic considerations prior to embarking upon a surgical course. Proper eyelid function depends upon the integrity of its constituent parts, including the margin, tarsus, muscle, and globe apposition. The lacrimal pump mechanism is produced by proper eyelid function and structure, and must be adequately assessed. The puncta and canaliculi are delicate structures and must be manipulated with care and gentleness. The lacrimal sac is a static structure that serves as a collecting sphere but also may be forced to evacuate its contents into the nasolacrimal duct by the "squeezing" action of the investing tendons. Proper tendon position must be maintained after surgery or trauma to facilitate this action. The nasolacrimal sac may be damaged after facial fractures or blocked from intranasal conditions. If the blockage cannot be relieved, it must be bypassed by performing a dacryocystorhinostomy. The use of long-term, indwelling silicone intubation catheters greatly facilitates the successful reconstruction of the lacrimal drainage system. Proper attention to all of these points will be appreciated by the patient.

Dacryocystitis↗

Lacrimal gland and fossa lesions: role of computed tomography.

The lacrimal gland region can be involved in a wide spectrum of orbital pathology, including tumors and inflammatory and lymphoid lesions. This article focuses special attention on benign mixed tumors because of the excellent prognosis for the patient when it is completely excised at first surgery. The appearance of these lesions on CT is detailed in the illustrations of this article, and the findings of experts in the field are presented as well.

Dacryocystitis↗

[Echographic diagnosis in tumors of the paranasal sinuses with invasion of the lacrimal ducts].

In 16 patients the histologically proven diagnosis of a lacrimal sac tumor was made; in 9 of them a paranasal sinus tumor had invaded the lacrimal pathways, in 7 patients existed a primary tumor of the lacrimal sac, A- and B-scan sonography allow a clear-cut differentiation of both these entities. Furthermore primary and tumor-related inflammations of the lacrimal pathways can be distinguished by echography, which thereby provides the decisive diagnostic basis for the different therapeutic procedures in each case.

Dacryocystitis↗

Nasolacrimal disorders and their treatment.

Dysfunction of the excretory part of the nasolacrimal system may be congenital in otherwise normal infants or associated with congenital facial anomalies. It may also occur as a result of soft-tissue trauma to the face and naso-orbital fractures. Dacryocystorhinostomy and conjunctivodacryocystorhinostomy are discussed as treatment techniques.

Chronic Disease↗

The watery eye.

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Dacryocystitis↗