Lacrimal Drainage System Problems After Rhinoplasty
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ORIGINAL ARTICLE
RHINOPLASTY
Lacrimal Drainage System Problems After Rhinoplasty Mansooreh Jamshidian_tehrani1 • Esmaeil Asadi Khameneh1 • Amirreza Veisi2,3
Received: 25 June 2020 / Accepted: 16 August 2020 Ó Springer Science+Business Media, LLC, part of Springer Nature and International Society of Aesthetic Plastic Surgery 2020
Abstract Background To report case series of permanent nasolacrimal system problems following rhinoplasty Methods The documents of patients with epiphora and history of rhinoplastic surgery were reviewed. The data of patients with permanent epiphora (continued over 3 months or started after 3 months of post-rhinoplasty surgery) and lacrimal drainage system (LDS) problems were analyzed for demographics, the result of diagnostic probing and irrigation, findings of orbital and paranasal sinuses CT scan, abnormalities in nasal endoscopy, treatment, and follow-up data. Results Forty-three patients with epiphora and history of rhinoplasty were referred to our clinic. Ten of them had permanent epiphora and LDS problems. In these patients, the mean time between rhinoplasty and initial symptoms of LDS problems was 10.3 ± 15.1 (range, 0–45 months) and the mean time between rhinoplasty and the LDS surgery was 22.2 ± 19.5 months (range 4–60 months). Diagnostic probing and irrigation test revealed canalicular stenosis in four (40%) patients, pus reflux in four (40%), clear reflux without passage in four (40%), and partial nasolacrimal duct obstruction (NLDO) in two (20%) of patients. DCR was performed in eight (80%) patients. Therapeutic
& Amirreza Veisi [email protected] 1
Eye Research Center, Department of Ophthalmology, Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran
2
Ophthalmic Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran
3
Labbafinejad Medical Center, Boostan 9 Street, Pasdaran Avenue, Tehran 16666, Iran
probing and lacrimal intubation were performed in two (20%) patients. Conclusion A permanent injury of the LDS is one of the important complications of the rhinoplastic surgery that should be managed based on the onset and duration of the symptoms and the location of the injury. Level of Evidence IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266. Keywords Epiphora Rhinoplasty Nasolacrimal duct obstruction Lacrimal drainage system injury
Introduction Rhinoplasty is one of the most common cosmetic procedures that are performed worldwide and in Iran [1, 2]. Surgeons use different techniques and osteotomy methods for rhinoplasty based on their preference. Because of the proximity of the lacrimal sac (LS) and nasolacrimal duct (NLD) to the surgical site of rhinoplasty, iatrogenic injury to the lacrimal drainage system (LDS) should be expected during the surgery. Besides, surgical site edema and congestion can compromise the function
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