Nasolacrimal Duct Obstruction: An Unusual Presentation of Sarcoidosis
| Autor: | Samih J Nassif, Alison Callahan, Elie E. Rebeiz, Devin Ruiz |
|---|---|
| Rok vydání: | 2020 |
| Předmět: |
Lacrimal bone
medicine.medical_specialty Sarcoidosis medicine.medical_treatment Dacryocystorhinostomy Physical examination 03 medical and health sciences Dacryocystitis 0302 clinical medicine Lacrimal Duct Obstruction medicine Humans 030223 otorhinolaryngology Nasolacrimal duct Granuloma medicine.diagnostic_test business.industry Middle Aged medicine.disease Lacrimal sac medicine.anatomical_structure Nasolacrimal duct obstruction Otorhinolaryngology 030221 ophthalmology & optometry Female Radiology business Nasolacrimal Duct |
| Zdroj: | Ear, nose,throat journal. 101(4) |
| ISSN: | 1942-7522 |
| Popis: | Lacrimal drainage system disorders leading to epiphora are a common ophthalmologic complaint. When such a patient is identified, the ophthalmologist frequently collaborates with the otolaryngologist to perform a dacryocystorhinostomy (DCR). In rare cases, sinonasal sarcoidosis may lead to nasolacrimal duct obstruction (NLD) and dacryocystitis. A 48-year-old Caucasian female was referred to the Otolaryngology clinic for evaluation of a 6-month history of persistent right-sided nasal obstruction and epiphora. After physical examination and computerized tomography (CT) scan, she was diagnosed with right NLD with dacryocystitis. The patient underwent right endoscopic DCR. Pathology from the lacrimal bone and nasal tissue demonstrated noncaseating granulomas suggestive of sarcoidosis. Postoperative evaluation including lung CT scan confirmed systemic sarcoidosis. Nasolacrimal duct obstruction very rarely is the presenting symptom in patients with sarcoidosis. Imaging is necessary to rule out other causes of NLD, and histopathology is essential for diagnosis. Noncaseating granulomas are found along the nasal tissue and lacrimal sac, specifically in the subepithelial layer. Treatment consists of DCR, either endoscopic or external. Both approaches achieve long-lasting resolution of symptoms but may require revision from inflammation and scarring. There is no consensus on the use of intraoperative or postoperative steroids. |
| Databáze: | OpenAIRE |
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