• 대한두개안면성형외과학회지
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• 제23권1호
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• pp.43-47
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• 2022

Primary lymphoma originating from the lacrimal drainage system is a rare disease. Such lymphomas are mostly B-cell in origin and present nonspecific symptoms. The treatment of malignant lymphoma of the lacrimal drainage system is slightly different. We present the case of a 71-year-old woman with a painless mass below the medial canthus. Computed tomography (CT) scan of the orbit revealed a mass invading the right lacrimal sac. An incision biopsy was obtained, and the pathologic findings suggested a diagnosis of primary diffuse large B-cell lymphoma of the lacrimal sac. The patient was treated with chemotherapy and intrathecal methotrexate. After completing eight cycles of chemotherapy, the patient was followed up by a CT scan, which revealed nearly total resolution of an ill-defined enhancing mass. At the time of this case report writing, the patient is in complete remission at six months with no other complications.

• Archives of Plastic Surgery
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• 제35권2호
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• pp.197-200
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• 2008

Purpose: A congenital lacrimal sac fistula is unusual and consists of a dimple opening below the medial canthal tendon that leads to the lacrimal sac. This anlage ducts occur when the lacrimal anlage cells proliferate and canalize rather than involute. And, the anomaly is usually not associated with any systemic abnormalities. Also congenital cleft of the earlobes is rarely seen among congenital ear anomalies. Therefore, we report rare case with symptomatic bilateral lacrimal fistula with the ear cleft. Methods: A 4-year-old boy was admitted with aggravated chronic maxillary sinusitis, recurrent chronic dacryocystitis, and epiphora. He had two minor anomalies including bilateral lacrimal fistula originated in lacrimal tear sac and unilateral transverse ear cleft. The patient had been operated with fistulectomy and perioperative antibiotics. A small vertical ellipse is made around the opening with sharp dissection. The tract is excised using the probe as the guide. Another probe is placed through the lower canaliculus to prevent the damage. A suture ligature of 6-0 Maxon is placed around the deepest point of the tract, which is then excised. Additional sutures are placed in the tissues to form a tight closure to prevent reestablishment of the fistula. The skin is closed with 6-0 Black Silk. Results: The patient recovered well without any complications such as infection, epiphora, and obstruction of lacrimal sac. Conclusion: Our case illustrates bilateral lacrimal anlage ducts in a patient with unilateral congenital ear cleft. We recommend careful evaluation of lacrimal system in these patients, especially bilateral case and other congenital anomalies. Finally, we recommend excision of the ducts when epiphora, infection, or chronic skin irritation occur.

• Anatomy and Cell Biology
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• 제55권3호
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• pp.277-283
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• 2022

To determine the morphology of the lacrimal sac fossa and bony nasolacrimal duct using computed tomography for obtaining detailed anatomical understanding of the drainage system and utilizing these measurements in planning for dacryocystorhinostomy (DCR) and nasolacrimal duct (NLD) obstruction in normal southwest (SW) population of Iran. One-hundred-sixty-five cases referred for the diagnosis of neuro-ophthalmic conditions were retrospectively studied. Measurements of lacrimal sac fossa were taken on three anatomical sections (upper, middle, and lower planes) utilizing a digital caliper/protractor instrument. Lacrimal thickness and two measurements of maxillary bone thickness were taken at each plane-namely, the "midpoint thickness" and the "maximum thickness." The anterior extent of the nasal mucosa and NLD width was also evaluated. The mean maximum thickness of the maxillary bone at the three anatomical planes of the lacrimal sac fossa was 4.07 mm, 4.78 mm, and 5.60 mm, respectively. The midpoint thickness of the maxillary bone at each plane was 2.38 mm, 1.99 mm, and 1.68 mm, respectively, in both sexs. The lacrimal bone thickness at each level was 0.76 mm, 0.69 mm, and 0.67 mm, respectively. The proportion of the lacrimal sac fossa comprising the lacrimal bone at lower plane was 43.57% and showed a positive correlation with age (P=0.01). The mean anteroposterior bony nasolacrimal diameter was 5.94 mm with no significant difference between patient sex and age. According to the results, its indicate that performing an osteotomy during DCR could be easier in the Iranian SW population compared to other ethnics.

• 고신대학교 의과대학 학술지
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• 제33권3호
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• pp.358-368
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• 2018

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography. Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group. Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group. However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness. In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so. Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

• 대한수의학회지
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• 제36권1호
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• pp.23-29
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• 1996

This study was carried out to identify the gross anatomical and radiographic characteristics of the nasolacrimal system of the Korean native goat. The results were as follows : The nasolacrimal system are composed of two lacrimal ducts, two lacrimal, canaliculus, one lacrimal sac and one nasolacrimal duct. The nasolacrimal duct was divided into proximal, middle and distal portion. The nasolacrimal duct took a straight course to be paralleled with nasal bones and opened close to the nostril on the medial surface of the alar fold. The diameter of lacrimal punctum, the length of eyelid margin to lacrimal punctum, the length of canaliculus and the diameter of lacrimal sac were 0.82~0.90mm, 1.06~1.54mm, 5.65~6.30mm and 1.77~2.06mm, respectively. The length of proximal, middle and distal nasolacrimal duct were 36.84~40.00mm, 23.53~24.31mm and 14.55~14.73mm, respectively. The diameter of the orifice of nasolacrimal duct, the length of lateral margin of nostril to orifice of nasolacrimal duct and the length of dorsum to orifice of nasolacrimal duct were 1.29~1.33mm, 12.97~12.53mm and 15.24~16.11mm. The skull index of Korean native goat was not significantly different from the length of nasolacrimal duct.

• 한국임상수의학회지
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• 제27권5호
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• pp.559-564
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• 2010

인의학에서 비루관의 기능적 폐쇄 검사에서 유용하게 사용되는 비루관신티그라피 검사를 정상 비글견에 적용하여 그 유용성을 알아보고자 하였다. 누비공신티그라피는 정상적인 비루관 개통이 임상적으로 확인된 6마리 비글견에서 시행하였다.정면상의 양측 눈을 100초 동안의 타임세팅으로 한 후 5분, 10분, 20분 영상을 얻고자 하였다. 20분영상에서 누관의 개통이 관찰되지 않으면 30분. 45분. 60분 지연 영상을 얻었다. 신티그라피 이후 획득한 각 영상에서 좌측, 우측의 눈물세관, 누낭, 비루관의 관심영역 (ROI)를 그린 후 각 각의 계수율을 측정한 후 시간별 계수율 표를 구하였다. 20분 내 개통률은 전체 12개 비루관 중 10개를 나타내어 검사개체 중 83.3%를 나타내고 있으며 30분내 개통률은 12개중 11개를 나타내어 개통률은 91.6%이다. 정상 개에서 누비공신티그라피의 영상은 개 비루관의 해부학적, 기능적 누도폐쇄의 진단법으로 유용하다고 판단되며 임상적인 연구에 기초자료로 활용될 수 있을 것으로 판단된다.

• 대한두개안면성형외과학회지
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• 제11권1호
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• pp.41-44
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• 2010

Purpose: The epicanthus is a specific feature in Asian. Many techniques have been described to eliminate the epicanthal fold: resection of glabellar skin, resection of medial canthal skin, V-Y advancement, V-W technique, modified Z-plasty, multiple Z-plasties, and others. The authors observed postoperative epiphora after correction of epicanthal fold by periciliary skin flap without damaging lacrimal duct. Methods: A 19-year-old woman underwent non-incisional blepharoplasty, septorhinoplasty, and periciliary epicanthoplasty. On her history, she didn't have any symptom of epiphora preoperatively. And there was no specific complaint of epiphora during the postoperative two weeks. However epiphora got worse from one month after the surgery. She was out of this country, so the patient re-visited the clinic on the postoperative six months for this on-going symptom. On an ophthalmologic examination, patient's lacrimal duct and sac was intact but both lacrimal puncta of the patient were covered with a thin membrane. This membrane was punctuated by a 25 gauge needle and dilated with a standard dilator. Results: After ophthalmologic treatment, no recurrence was observed during five weeks of follow-up periods. Conclusion: Both lacrimal puncta of the patient were only covered with membranes. And we could not confirm the direct relationship between periciliary epicanthoplasty and postoperative epiphora. The probable factors will be a predisposing narrowed punctum, post operative peri-punctal edema and decrease in muscular function of orbicularis oculi.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제14권4호
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• pp.322-326
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• 1992

Epiphora is overflow of tears due to obstruction of lacrimal duct. Dacryocystorhinostomy is the most common procedure to eliminate the epiphora secondary to complete or partial obstruction of the nasolacrimal duct. The procedure is to artificially create passage between lacrimal sac and nasal cavity. Especially, epiphora would be accompany often by nasolacrimal duct obstruction when trauma of oromaxillofacial area lead to nasal fracture, medial wall fracture of orbit. Therefore in this case there are many case to perform dacryocystorhinostomy because probing and tubing is difficult to resolve the epiphora. We performed 4 cases of dacryocystorhinostomy for adult nasolacrimal duct obstruction from May 1991 to October 1991. The results were very satisfactory in all the case. Epipora disappeared in all case.

• Archives of Plastic Surgery
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• 제37권4호
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• pp.504-508
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• 2010

Purpose: Traumatic telecanthus can result from nasoethmoid-orbital fractures. Repair of the medial canthal tendon (MCT) using transnasal wiring is regarded as a choice of method to treat telecanthus, however, is often complicated by incomplete anchoring and drift of canthus, extrusion of wire, in-fracture of orbital bone, and eye damage. The authors introduced oblique transnasal wiring method through the Hiraga's epicanthopalsty incision instead of well-known classical bicoronal approach. Methods: Five patients with traumatic telecanthus were treated with this method. Though the Hiraga's epicanthoplasty incision, we could approach the operative field; the medial orbital wall and detached MCT. Oblique transnasal wiring was performed as following steps. After slit skin incision on the contralateral nasal recession area, drill holes were made from this point to the superior and posterior point of lacrimal sac of deformed eye. A 2-0 wire was double-passed through the holes and MCT. Traction was applied to ensure pulling the MCT and the wires were twisted in the contralateral nose, securing the MCT in the correct position. Results: All patients except 1 person showed improvement and rapid recovery. On average each canthus was moved 5.6 mm medially. In all cases, there were no eyelashes disappear, lacrimal canaliculitis, lacrimal duct injury, or infections. Conclusion: The Hiraga's epicanthoplasty incision could give sufficient operative field to reattach the MCT in traumatic telecanthus patients. And the oblique transnasal wiring technique is effective for the Asians who have flat nose and exophthalmic eye. The authors conclude that this technique could be a simple, safe and scarless method to correct traumatic telecanthus.

• 한국어류학회지
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• 제26권4호
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• pp.281-287
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• 2014

수중과 육상의 이중적인 생활을 하는 남방짱뚱어 Scartelaos gigas (amphibious mudskipper)의 후각기관을 해부학과 조직학적으로 연구하였다. 그 결과 후각기관은 좌우 한 쌍이 존재하며 각 기관은 한 개의 가느다란 긴관 (an elongated canal)과 사비강과 누비강의 두 개의 비강 (ethmoidal and lacrimal nasal sacs)으로 구성되어 있었다. 각 관의 내벽에 발달한 감각 상피는 3~4개의 섬모를 가지는 감각 수용기 세포 (receptor cell), 지지세포 (supporting cell), 기저세포 (basal cell) 그리고 점액세포 (mucus cell)들로 구성되는 다세포성 구조로 이루어져 있었다. 반면에 비감각 상피는 감각기를 갖지 않는 주름진 표면만을 가지고 있었다. 또한 두 개의 비강은 상피 표면에 점액 방울 (mucin droplet)을 가지고 있었다. 따라서 남방짱뚱어의 이러한 후각기관의 특징은 생태적 습성과 서식처에 관련된 반수중 생활 (semi-aquatic life)에 적응한 특징으로 사료된다.