Kallman J E, Foster J A, Wulc A E, Yousem D M, Kennedy D W
The Hospital of the University of Pennsylvania, Philadelphia, USA.
Ophthalmology. 1997 Apr;104(4):676-82. doi: 10.1016/s0161-6420(97)30252-8.
Acquired nasolacrimal duct obstruction is a common ophthalmologic problem. Despite widespread understanding of treatments available for nasolacrimal duct obstruction, few authors have commented on its etiology. Because the nasolacrimal system is anatomically related to important nasal and sinus structures, the authors postulated that acquired nasolacrimal duct obstruction and its complications might occur simultaneous to, and possibly as a consequence of, rhinologic or sinus disease.
Twenty-three patients with acquired nasolacrimal duct obstruction and 100 control patients were evaluated by coronal computed tomography for evidence of sinus disease or nasal abnormalities. Specifically, five findings were noted: ostiomeatal complex disease, ethmoidal opacification, agger nasi cell opacification, concha bullosa, and nasal septal deviation.
Overall, 20 (87%) patients with acquired nasolacrimal duct obstruction demonstrated one or more radiologic finding of sinus disease or rhinologic abnormality whereas 63 (63%) control subjects exhibited these findings. This difference was determined to be statistically significant (P < 0.05). A statistically significant higher incidence of ethmoidal opacification, agger nasi cell opacification, and nasal septal deviation was observed in patients with nasolacrimal outflow obstruction than in controls. Differences in the incidence of ostiomeatal complex disease and concha bullosa were not found to be statistically significant.
These data demonstrate a correlation between computed tomography findings of sinus disease or nasal abnormality and the presence of acquired nasolacrimal outflow obstruction. This association between radiologic evidence of sinorhinologic disorders and lacrimal outflow obstruction may imply that dacryocystitis, like sinus disease, may be produced by disease of the lateral nasal wall. When evaluating a patient with acquired nasolacrimal duct obstruction, the physician should consider evaluation for concomitant nasal and sinus disease.
获得性鼻泪管阻塞是一种常见的眼科问题。尽管人们对鼻泪管阻塞的现有治疗方法有广泛的了解，但很少有作者对其病因进行评论。由于鼻泪系统在解剖学上与重要的鼻腔和鼻窦结构相关，作者推测获得性鼻泪管阻塞及其并发症可能与鼻科或鼻窦疾病同时发生，并且可能是其结果。
对23例获得性鼻泪管阻塞患者和100例对照患者进行冠状位计算机断层扫描，以寻找鼻窦疾病或鼻腔异常的证据。具体而言，记录了五项发现：窦口鼻道复合体疾病、筛窦混浊、鼻丘气房混浊、泡状鼻甲和鼻中隔偏曲。
总体而言，20例（87%）获得性鼻泪管阻塞患者表现出一项或多项鼻窦疾病或鼻科异常的影像学发现，而63例（63%）对照受试者有这些发现。这种差异具有统计学意义（P < 0.05）。与对照组相比，鼻泪管流出道阻塞患者筛窦混浊、鼻丘气房混浊和鼻中隔偏曲的发生率在统计学上显著更高。未发现窦口鼻道复合体疾病和泡状鼻甲发生率的差异具有统计学意义。
这些数据表明鼻窦疾病或鼻腔异常的计算机断层扫描结果与获得性鼻泪管流出道阻塞之间存在相关性。鼻窦疾病的影像学证据与泪道流出道阻塞之间的这种关联可能意味着泪囊炎，与鼻窦疾病一样，可能由鼻腔外侧壁疾病引起。在评估获得性鼻泪管阻塞患者时，医生应考虑对同时存在的鼻腔和鼻窦疾病进行评估。
