The Journal of Laryngology & Otology

Table of Contents - December 2011 - Volume 125, Issue 12  

Clinical Records

Dacryolith in an unusual case of epiphora: open or endoscopic approach?

C Gadepallia1 c1, V Malika1, C Inkstera2 and C Loboa1

a1 Department of ENT, Royal Bolton NHS Trust, UK

a2 Department of Ophthalmology, Royal Bolton NHS Trust, UK

Abstract

Introduction: Dacryoliths are concretions formed in the lacrimal sac from cellular debris and proteins, which may calcify and cause further obstruction of the nasolacrimal pathway. Dacryoliths are often underlying contributors in cases of intermittent or chronic dacryocystitis (i.e. nasolacrimal sac inflammation, characterised by epiphora, pain, erythema, sac dilation and lacrimal punctum swelling).

Objective: We report an unusual case of dacryolith resulting in obstructive epiphora, managed via an endonasal endoscopic approach.

Method: Case report and literature review pertaining to dacryolith.

Results: A 54-year-old man attended the multidisciplinary nasolacrimal clinic due to recurrent epiphora. Obstructive epiphora secondary to chronic dacryocystitis was diagnosed. He underwent endonasal endoscopic dacryocystorhinostomy. Intra-operatively, a large dacryolith was found to be the cause of epiphora.

Conclusion: Dacryolith is an unusual cause of nasolacrimal duct obstruction. This case highlights this unusual cause, and the relevant diagnostic investigations. This case also illustrates successful endonasal endoscopic management, rather than an external, open approach.

(Accepted March 07 2011)

(Online publication August 19 2011)

Key words

Correspondence:

c1 Address for correspondence: Mr C Gadepalli, 10 Bispham Rd, Great Sankey, Warrington WA5 2SU, UK E-mail: chai32@yahoo.com

Footnotes

Mr C Gadepalli takes responsibility for the integrity of the content of the paper

Competing interests: None declared

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