Yazıcıoğlu Titap, Ağaçkesen Anıl, Adıgüzel Karaoysal Özge
Kartal Dr.Lütfi Kırdar City Hospital, Ophthalmology Clinic, İstanbul, Turkey.
Kartal Dr.Lütfi Kırdar City Hospital, Radiology Clinic, İstanbul, Turkey.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):2135-2140. doi: 10.1007/s00405-024-09193-9. Epub 2025 Jan 5.
To compare the nasolacrimal and nasal anatomical parameters in cases of acquired primary nasolacrimal duct obstruction and acute dacryocystitis.
The study included 62 eyes of 31 patients. The eyes were divided into three groups: Group A, comprising eyes presenting with acute dacryocystitis; Group B, comprising eyes with nasolacrimal duct obstruction but no previous episodes of dacryocystitis; and Group C, comprising eyes with an patent nasolacrimal duct. The coronal, axial, and sagittal computed tomography images of the cases were examined to assess parameters such as the canal's entry and exit, the narrowest transverse and anteroposterior diameters, the anatomical type of the canal, inferior turbinate thickness, the angle between the inferior turbinate and the medial maxillary wall, and the direction of septal deviation.
No significant difference was found in any parameter when comparing eyes with acquired primary nasolacrimal duct obstruction to the contralateral eyes without obstruction (p > 0.05). Among the three groups, eyes with acute dacryocystitis (Group A) had significantly wider exit transverse and narrowest anteroposterior diameters compared to the other two groups (p = 0.000, p = 0.001, and p = 0.006, p = 0.042), with the narrowest transverse diameter also being significantly wider compared to Group B (p = 0.007). The angle of the inferior turbinate was significantly lower in Group A compared to Group B (p = 0.038). There was no significant difference between the groups regarding the anatomical type of the canal (p = 0.981).
While anatomical parameters do not show significant differences between eyes with primary acquired nasolacrimal duct obstruction and those without obstruction in the same individual, the wider canal diameters in eyes with acute dacryocystitis suggest that secondary changes associated with dacryocystitis or a predisposition to dacryocystitis might be present in eyes with nasolacrimal duct obstruction.
比较获得性原发性鼻泪管阻塞和急性泪囊炎病例的鼻泪管及鼻腔解剖参数。
该研究纳入了31例患者的62只眼。这些眼睛被分为三组：A组，包括表现为急性泪囊炎的眼睛；B组，包括有鼻泪管阻塞但既往无泪囊炎发作的眼睛；C组，包括鼻泪管通畅的眼睛。检查病例的冠状位、轴位和矢状位计算机断层扫描图像，以评估诸如鼻泪管的入口和出口、最窄横径和前后径、鼻泪管的解剖类型、下鼻甲厚度、下鼻甲与上颌骨内侧壁之间的角度以及鼻中隔偏曲方向等参数。
将获得性原发性鼻泪管阻塞的眼睛与对侧无阻塞的眼睛进行比较时，在任何参数上均未发现显著差异（p>0.05）。在三组中，与其他两组相比，急性泪囊炎患者的眼睛（A组）出口横径明显更宽，最窄前后径也明显更宽（p = 0.000，p = 0.001，p = 0.006，p = 0.042），其最窄横径也比B组明显更宽（p = 0.007）。A组下鼻甲的角度明显低于B组（p = 0.038）。在鼻泪管的解剖类型方面，各组之间无显著差异（p = 0.981）。
虽然解剖参数在同一患者中获得性原发性鼻泪管阻塞的眼睛与无阻塞的眼睛之间未显示出显著差异，但急性泪囊炎患者眼睛中更宽的鼻泪管直径表明，鼻泪管阻塞患者的眼睛中可能存在与泪囊炎相关的继发性改变或泪囊炎易感性。
