Computed tomography of the lacrimal drainage system: Retrospective study of 107 cases of dacryostenosis

Purpose: To evaluate the role of computed tomography in patients with dacry ostenosis. Methods: One hundred seven cases of dacryostenosis (94 patients) were asses sed by thorough clinical and lacrimal history and examination, and lacrimal region computerized tomography (CT). The lacrimal drainage system examinat ion included the state and position of the puncta; Jones testing; lacrimal syringing; and, in the latter half of the study, telescopic nasal endoscopy . The patients were drawn from the hospital outpatients and private office of the operating lacrimal surgeon in this series (I.C.F.). Of the 107 cases , 79 either underwent dacryocystorhinostomy surgery or had this planned. Results: In 14 of the 107 cases (12 patients), preoperative CT led to an al teration of patient management, usually referral to an otolaryngologist for further evaluation or treatment. In addition to the detection of two tumor s extrinsic to the sac, conditions such as ethmoiditis, lacrimal sac mucoce les, soft tissue opacity in the nasolacrimal duct, gross nasal polyposis, f ungal sinusitis, and a dacryolith were observed by CT. Conclusion: Similar to the role of functional endoscopic sinus surgery in o tolaryngology, CT imaging will become increasingly important in the assessm ent of many patients with symptoms of lacrimal drainage obstruction.