Department of Oculoplastic, Orbital & Lacrimal Surgery, Aichi Medical University Hospital, Nagakute, Japan.
Department of Otorhinolaryngology-Head and Neck Surgery, Aichi Medical University School of Medicine, Nagakute, Japan.
Ophthalmic Plast Reconstr Surg. 2024;40(3):e84-e86. doi: 10.1097/IOP.0000000000002599. Epub 2024 Feb 5.
A 47-year-old Japanese woman presented with a 1-year history of right-sided epiphora. On initial consultation, the patient had a high right tear meniscus height. CT images revealed bilateral soft tissue opacification in the nasal cavity and maxillary, frontal, and ethmoid sinuses. The lesion in the right nasal cavity and maxillary sinus involved the right lacrimal sac and nasolacrimal duct. Blood test results showed elevated eosinophil count. Endoscopic sinus surgery and excisional biopsy of the nasolacrimal duct were performed. Histopathological examinations of the excised right nasolacrimal duct and nasal polyps from the nasal cavity and maxillary sinus showed high levels of eosinophilic inflammatory infiltrates. The definite diagnosis of eosinophilic chronic rhinosinusitis was made, based on clinical, radiological, and histopathological findings. At 1.5-year follow-up, tear meniscus height was normal, the lacrimal drainage system remained patent, and the rhinosinusitis did not recur.
一位 47 岁的日本女性因右侧溢泪就诊，病史 1 年。初次就诊时，患者右眼的泪膜高度较高。CT 图像显示双侧鼻腔和上颌窦、额窦和筛窦软组织混浊。右侧鼻腔和上颌窦的病变累及右侧泪囊和鼻泪管。血液检查结果显示嗜酸性粒细胞计数升高。患者接受了鼻内镜鼻窦手术和鼻泪管切除术。切除的右侧鼻泪管和鼻腔及上颌窦的鼻息肉的组织病理学检查显示嗜酸性粒细胞炎症浸润程度高。根据临床、影像学和组织病理学检查结果，明确诊断为嗜酸性慢性鼻-鼻窦炎。在 1.5 年的随访中，泪膜高度正常，泪液引流系统通畅，且未再发生鼻-鼻窦炎。
