[Presaccal stenosis as a cause of epiphora].

BACKGROUND

Dacryocystographic evaluation of the location of stenoses of the lacrimal pathways was carried out in patients with epiphora to define the frequency and morphology of canalicular stenosis.

PATIENTS AND METHODS

Digital subtraction angiography (DSA) dacryocystograms of 55 consecutive patients with severe epiphora and stenoses of the lacrimal draining system were reviewed in a consensus between three evaluators to determine radiomorphologic criteria for the diagnosis of canalicular stenosis. In 9 cases 3D rotational dacryocystography was additionally used.

RESULTS

A total of 80 stenotic lesions were detected including 19 (24%) canalicular, 26 (32%) saccal and 35 (44%) ductal stenoses. In 9 of the patients 3D rotational dacryocystography was used to differentiate between canalicular (n=4) and saccal (n=5) stenosis. Increased resistance during continuous injection of contrast material and lack of distension of the distal ductal system were the main criteria for diagnosis of canalicular stenosis.

CONCLUSION

Presaccal stenoses accounted for nearly 25% of the stenoses found in this study. This type of stenosis occurs frequently and should not be overlooked on dacryocystography. 3D rotational dacryocystography may be helpful in unclear cases.