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Krishnanunni K, Parameswaran A, Tangutur SP. Evaluation of nasolacrimal canal morphology in different facial skeletal relationships. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2024; 125:101722. [PMID: 38042348 DOI: 10.1016/j.jormas.2023.101722] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 11/29/2023] [Accepted: 11/30/2023] [Indexed: 12/04/2023]
Abstract
BACKGROUND Abnormal morphological variations of nasolacrimal canal (NLC) and its lack of understanding contributes to acquired injuries during craniomaxillofacial surgical procedures which leads untoward postoperative complications like nasolacrimal obstruction (NLO) and epiphora. PURPOSE The purpose of this study was to determine dimensional and volumetric morphological variations of nasolacrimal canal in various facial skeletal relationships which aid in performing a precise and safe surgery. MATERIALS AND METHODS This retrospective cohort study involved dimensional and volumetric analysis of nasolacrimal canal procured from computed tomography scans of 47 individuals grouped as ClassI, Class II and Class III, and unilateral cleft lip and palate (UCLP) groups. The outcome variables included length of NLC, volume of NLC, distance between the inferior orifice of the NLC to nasal floor, distance between inferior orifice of NLC to canine apex and distance between inferior orifice of NLC to central incisor apex. The objectives were to analyse morphological variation of NLC in different facial skeletal relationships and to evaluate the variation with change in facial sides and its relationship with surrounding structures. RESULTS Volume of the NLC was found significant in Class I and UCLP population (p < 0.05) with the greatest volume in the UCLP group. The mean linear and volumetric measurements between the right and left sides were found insignificant among all groups. Inferior orifice of NLC from canine apex were farthest in Class III and nearest in the UCLP group (p < 0.05). There was no significant association between outcome variables and skeletal base configuration. CONCLUSION NLC demonstrates dimensional and anthropometric variations between different skeletal relationships and this study is inevitable in understanding the probability of NLC injury during maxillofacial surgeries.
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Affiliation(s)
- Keerthi Krishnanunni
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu 600095, India
| | - Anantanarayanan Parameswaran
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu 600095, India.
| | - Srinivasa Prasad Tangutur
- Department of Oral and Maxillofacial Surgery, Meenakshi Ammal Dental College and Hospital, Chennai, Tamil Nadu 600095, India
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Chen Z, Wang J. Diagnostic capability and radiation dose of cone beam CT dacryocystography in different scanning fields of view in healthy volunteers. Radiol Med 2020; 126:47-54. [DOI: 10.1007/s11547-020-01227-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Accepted: 05/12/2020] [Indexed: 12/11/2022]
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Cârstocea L, Rusu MC, Mateşică DŞ, Săndulescu M. Air spaces neighbouring the infraorbital canal. Morphologie 2019; 104:44-50. [PMID: 31492524 DOI: 10.1016/j.morpho.2019.07.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2019] [Revised: 07/29/2019] [Accepted: 07/29/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The infraorbital canal (IOC) courses through the roof of the maxillary sinus (MS). Different grading systems concerning the topography of the IOC have been proposed. Further, it has been suggested that a transantral IOC would be morphologically related to Haller's cells (HCs). However, we hypothesized that this is not necessarily the case. Hence, we aimed to study the anatomical possibilities of the air spaces located medially to the IOC. MATERIALS AND METHODS The cone-beam computed tomography (CBCT) files of 40 adult patients were retrospectively evaluated. RESULTS The transantral type of IOC was found in 32.5% of patients. The infraorbital recesses of the MS were found medial to the IOC in 20% of patients. As referred to the nasolacrimal canal, these recesses were either prelacrimal (appearing as false isolated air cells) or retrolacrimal (appearing as false HCs). True HCs were found in 10% of patients. They were located medial to the IOC and they drained into the ethmoidal infundibulum (EI), which was distinct from the MS drainage. In 15% of patients, aerated nasolacrimal ducts (NLDs) were found anterior to the EI and medial to the antral angle. They were capable of masquerading either a HC or an infraorbital recess of the MS. CONCLUSION Previous classifications of the IOC, which related it to HCs, were reviewed and the evidence was found to be insufficient to assess the HC-related topography of the IOC. Therefore, to achieve the accurate anatomical identification of the air spaces neighbouring the IOC, the infraorbital recesses of the MS, the HCs, and the aerated NLDs should be carefully discriminated within the antero-supero-medial antral angle.
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Affiliation(s)
- L Cârstocea
- Division of Anatomy, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - M C Rusu
- Division of Anatomy, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - D Ş Mateşică
- Division of Anatomy, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
| | - M Săndulescu
- Division of Implant Prosthetic Therapy, Faculty of Dental Medicine, Carol Davila University of Medicine and Pharmacy, Bucharest, Romania.
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Soriano LM, Damasceno NA, Herzog Neto G, Damasceno EF. Comparative study of the clinical profile of chronic dacryocystitis and chronic rhinosinusitis after external dacryocystorhinostomy. Clin Ophthalmol 2019; 13:1267-1271. [PMID: 31409965 PMCID: PMC6643063 DOI: 10.2147/opth.s200923] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 06/20/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose To compare the clinical profile of patients with chronic dacryocystitis (CDC) with and without associated chronic rhinosinusopathies who had been submitted to external dacryocystorhinostomy (EDCR). Methods This was a retrospective, observational, and longitudinal study that included all patients diagnosed with CDC who were submitted to EDCR at the Antonio Pedro University Hospital. Patients were divided into two groups, with and without rhinosinusopathies (Group I and Group II, respectively). The following variables were assessed to compare the Group I and Group II: age, ethnicity, epiphora, discharge by expression of the lacrimal sac, duration of the CDC, and previous history of CDC exacerbation. Results The study included a total of 78 patients, 22 patients (28.2%) in Group I and 56 patients (71.8%) in Group II. The mean age was 64.3 (±19.7) years. In Group I and II predominated elderly, female, and White (p=0.93, p=0.38, p=0.77). In relation to the clinical characteristics, most of the patients presented epiphora and discharge by compression of the lacrimal sac in both Groups (p=0.61, p=0.44). In relation to a previous history of exacerbations of the CDC, six patients in Group I and four patients in Group II presented it as purulent discharge (p=0.04). Conclusion Chronic rhinosinusopathies may favor episodes of exacerbations of chronic dacryocystitis in particular with the presence of purulent discharge.
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Affiliation(s)
- Luciana Mc Soriano
- Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil
| | - Nadyr A Damasceno
- Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil.,Department of Ophthalmology, Hospital Naval Marcílio Dias, Rio de Janeiro, Brazil
| | | | - Eduardo F Damasceno
- Department of Ophthalmology, Universidade Federal Fluminense, Niterói, Brazil
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Sullivan DA, Rocha EM, Aragona P, Clayton JA, Ding J, Golebiowski B, Hampel U, McDermott AM, Schaumberg DA, Srinivasan S, Versura P, Willcox MDP. TFOS DEWS II Sex, Gender, and Hormones Report. Ocul Surf 2017; 15:284-333. [PMID: 28736336 DOI: 10.1016/j.jtos.2017.04.001] [Citation(s) in RCA: 236] [Impact Index Per Article: 33.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2017] [Accepted: 04/16/2017] [Indexed: 12/21/2022]
Abstract
One of the most compelling features of dry eye disease (DED) is that it occurs more frequently in women than men. In fact, the female sex is a significant risk factor for the development of DED. This sex-related difference in DED prevalence is attributed in large part to the effects of sex steroids (e.g. androgens, estrogens), hypothalamic-pituitary hormones, glucocorticoids, insulin, insulin-like growth factor 1 and thyroid hormones, as well as to the sex chromosome complement, sex-specific autosomal factors and epigenetics (e.g. microRNAs). In addition to sex, gender also appears to be a risk factor for DED. "Gender" and "sex" are words that are often used interchangeably, but they have distinct meanings. "Gender" refers to a person's self-representation as a man or woman, whereas "sex" distinguishes males and females based on their biological characteristics. Both gender and sex affect DED risk, presentation of the disease, immune responses, pain, care-seeking behaviors, service utilization, and myriad other facets of eye health. Overall, sex, gender and hormones play a major role in the regulation of ocular surface and adnexal tissues, and in the difference in DED prevalence between women and men. The purpose of this Subcommittee report is to review and critique the nature of this role, as well as to recommend areas for future research to advance our understanding of the interrelationships between sex, gender, hormones and DED.
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Affiliation(s)
- David A Sullivan
- Schepens Eye Research Institute, Massachusetts Eye and Ear, Harvard Medical School, Boston, MA, USA.
| | - Eduardo M Rocha
- Ribeirão Preto Medical School, University of São Paulo, São Paulo, Brazil
| | - Pasquale Aragona
- Department of Biomedical Sciences, Ocular Surface Diseases Unit, University of Messina, Messina, Sicily, Italy
| | - Janine A Clayton
- National Institutes of Health Office of Research on Women's Health, Bethesda, MD, USA
| | - Juan Ding
- Schepens Eye Research Institute, Massachusetts Eye & Ear, Department of Ophthalmology, Harvard Medical School, Boston, MA, USA
| | - Blanka Golebiowski
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
| | - Ulrike Hampel
- Department of Ophthalmology, University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Alison M McDermott
- The Ocular Surface Institute, College of Optometry, University of Houston, Houston, TX, USA
| | - Debra A Schaumberg
- Harvard School of Public Health, Boston, MA, USA; University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Sruthi Srinivasan
- Centre for Contact Lens Research, School of Optometry, University of Waterloo, Ontario, Canada
| | - Piera Versura
- Department of Specialized, Experimental, and Diagnostic Medicine, University of Bologna, Bologna, Italy
| | - Mark D P Willcox
- School of Optometry and Vision Science, University of New South Wales, Sydney, Australia
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Choi SC, Lee S, Choi HS, Jang JW, Kim SJ, Lee JH. Preoperative Computed Tomography Findings for Patients with Nasolacrimal Duct Obstruction or Stenosis. KOREAN JOURNAL OF OPHTHALMOLOGY 2016; 30:243-50. [PMID: 27478350 PMCID: PMC4965598 DOI: 10.3341/kjo.2016.30.4.243] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2015] [Accepted: 11/03/2015] [Indexed: 12/04/2022] Open
Abstract
Purpose To identify and analyze the role of preoperative computed tomography (CT) in patients with tearing symptoms with nasolacrimal duct obstruction (NLDO). Methods We retrospectively reviewed the medical records and CT results on 218 patients who complained of tearing symptoms with NLDO between January 2014 and December 2014. All patients were recruited from Kim's Eye Hospital's outpatient clinic and assessed by clinical history, examination, and CT to evaluate periocular pathology and nasolacrimal drainage system. Patients with abnormal findings assessed by preoperative CT were further reviewed. Results CT was performed on 218 patients (average age, 58.2 ± 11.9 years). Of these, 196 (89.9%) had endonasal dacryocystorhinostomy, 14 (6.4%) declined surgery, and 8 (3.7%) were inoperable due to abnormal CT findings. Soft tissue opacity was the most common finding which 243 cases (85.9%) of 283 obstructed nasolacrimal duct and 89 cases (81.7%) of 109 non-obstructed nasolacrimal duct showed it. Thirty-nine (17.8%) of 218 patients showed either maxillary sinusitis or ethmoidal sinusitis and 32 (14.7%) of 218 patients presented with periocular inflammation. Other abnormal CT findings included septal deviations, previous fractures, masses, and structural abnormalities of nasal cavity. Conclusions Preoperative CT imaging is useful in the assessment of both nasolacrimal drainage and nearby anatomical structures. This information will be helpful in planning surgical interventions and management of NLDO.
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Affiliation(s)
- Seong Chan Choi
- Myunggok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Saem Lee
- Myunggok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Hye Sun Choi
- Myunggok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Jae Woo Jang
- Myunggok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Sung Joo Kim
- Myunggok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
| | - Jung Hye Lee
- Myunggok Eye Research Institute, Department of Ophthalmology, Kim's Eye Hospital, Konyang University College of Medicine, Seoul, Korea
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Jañez-Garcia L, Saenz-Frances F, Ramirez-Sebastian JM, Toledano-Fernandez N, Urbasos-Pascual M, Jañez-Escalada L. Three-Dimensional Reconstruction of the Bony Nasolacrimal Canal by Automated Segmentation of Computed Tomography Images. PLoS One 2016; 11:e0155436. [PMID: 27187800 PMCID: PMC4871497 DOI: 10.1371/journal.pone.0155436] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2016] [Accepted: 04/28/2016] [Indexed: 11/18/2022] Open
Abstract
Objective To apply a fully automated method to quantify the 3D structure of the bony nasolacrimal canal (NLC) from CT scans whereby the size and main morphometric characteristics of the canal can be determined. Design Cross-sectional study. Subjects 36 eyes of 18 healthy individuals. Methods Using software designed to detect the boundaries of the NLC on CT images, 36 NLC reconstructions were prepared. These reconstructions were then used to calculate NLC volume. The NLC axis in each case was determined according to a polygonal model and to 2nd, 3rd and 4th degree polynomials. From these models, NLC sectional areas and length were determined. For each variable, descriptive statistics and normality tests (Kolmogorov-Smirnov and Shapiro-Wilk) were established. Main Outcome Measures Time for segmentation, NLC volume, axis, sectional areas and length. Results Mean processing time was around 30 seconds for segmenting each canal. All the variables generated were normally distributed. Measurements obtained using the four models polygonal, 2nd, 3rd and 4th degree polynomial, respectively, were: mean canal length 14.74, 14.3, 14.80, and 15.03 mm; mean sectional area 15.15, 11.77, 11.43, and 11.56 mm2; minimum sectional area 8.69, 7.62, 7.40, and 7.19 mm2; and mean depth of minimum sectional area (craniocaudal) 7.85, 7.71, 8.19, and 8.08 mm. Conclusion The method proposed automatically reconstructs the NLC on CT scans. Using these reconstructions, morphometric measurements can be calculated from NLC axis estimates based on polygonal and 2nd, 3rd and 4th polynomial models.
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Affiliation(s)
- Lucia Jañez-Garcia
- Ramon Castroviejo Institute of Ophthalmological Investigations, Complutense University, Madrid, Spain
| | - Federico Saenz-Frances
- Ophthalmology Department, Clinico Universitario San Carlos Hospital, Complutense University, Madrid, Spain
- * E-mail:
| | - Jose M. Ramirez-Sebastian
- Ramon Castroviejo Institute of Ophthalmological Investigations, Complutense University, Madrid, Spain
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