a1 Department of ENT, Royal Bolton NHS Trust, UK
a2 Department of Ophthalmology, Royal Bolton NHS Trust, UK
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)
Mr C Gadepalli takes responsibility for the integrity of the content of the paper
Competing interests: None declared