Nasolacrimal duct obstruction secondary to ectopic teeth

Objective: To describe two patients with nasolacrimal duct obstruction (NLD O) caused by ectopic eruption of teeth. The literature concerning nasal and other unusual ectopic sites of tooth eruption is reviewed. Design: Two interventional case reports and literature review, Participants: A 3-year-old girl with epiphora and recurrent dacryocystitis of the right eye. Previous medical and surgical management was unsuccessful . A 32-year-old female with a long history of right eye discomfort and epip hora. Previous examinations and workup were negative. Intervention: A computed tomographic (CT) scan of the orbits and sinuses wa s performed in both patients. The ectopic teeth were surgically removed. Main Outcome Measures: Nasolacrimal system function and response to treatme nt at the last follow-up were recorded. Results: In the first patient, CT imaging disclosed two teeth within the ri ght inferior meatus compressing the nasolacrimal duct. In the second patien t, CT revealed a large dental structure in the maxillary sinus compressing the nasolacrimal duct. Endoscopic tooth extraction and nasolacrimal duct pr obing in the first patient and surgical removal of the dental structure in the second patient effected complete resolution of symptoms. Both patients were symptom free at last follow-up. Conclusions: These cases suggest that ectopic eruption of teeth should be a dded to the differential diagnosis of NLDO. Surgical removal of the ectopic teeth compressing the nasolacrimal duct results in resolution of the lacri mal drainage obstruction. Ophthalmology 2000; 107:189-192 (C) 2000 by the A merican Academy of Ophthalmology.