BILATERAL NASOLACRIMAL DUCT OBSTRUCTION MANAGED WITH ENDOSCOPIC TECHNIQUES

We present 3 cases of bilateral acquired nasolacrimal duct obstruction secondary to Wegener granulomatosis, sarcoidosis, and chronic lymphoc ytic leukemia. In all cases significant paranasal sinus and intranasal disease coincided with bilateral nasolacrimal duct obstruction. Surgi cal treatment of the nasolacrimal duct obstruction with dacryocystorhi nostomy was more successful if the paranasal sinus disease was also tr eated. Nontraumatic bilateral nasolacrimal duct obstruction heralds un usual underlying systemic diseases, and coexisting paranasal sinus dis ease should be suspected. The simultaneous surgical treatment of both lacrimal and paranasal sinus disease through an endoscopic approach is advocated.