Nasolacrimal Duct Orifice: A Cadaveric Study in Relation to Important Anatomical Landmarks

Vrinda Hari Ankolekar, Mamatha Hosapatna, Aswin Das M, Supriya, Anne D Souza

The nasolacrimal apparatus is intimately associated with the lateral nasal wall and may be approached using an endoscopic technique. This study was undertaken to describe in detail the gross anatomy of the nasolacrimal duct orifice in relation to various landmarks of the lateral nasal wall to improve the safety and efficiency of endoscopic surgical procedures. The study was conducted on 25 sagittal sections of adult cadavers in the Department of Anatomy, Kasturba Medical College, Manipal. The parameters measured were the distance from nasolacrimal duct orifice (NO) to the anterior end of middle concha (MC), distance from NO to the anterior nasal spine (ANS), distance from NO to the nasal floor (NF), distance from NO to anterior end of the inferior concha (AIC), and distance from NO to posterior end of the inferior concha (PIC). The shape of the NO was also observed and classified as oval, round and slit. The distance from NO to ANS was 2.73± 0.26 cm, the distance from NO to NF was 1.19± 0.34 cm, the distance between NO to MC, NO to AIC and PIC were 2.55 ±0.28 cm, 1.85±0.3 cm and 3.4±0.36 cm respectively. We also observed 3 types of shapes of NO, majority were slit like followed by oval and round. Knowledge of the anatomy of the nasolacrimal apparatus is essential for the surgeon during the performance of endonasal cystorhinostomies and maxillary osteotomies

___

1. Demas PN, Sotereanos GC. Incidence of nasolacrimal injury and turbinectomy-- associated atrophic rhinitis with Le Fort I osteotomies. J Craniomaxillofac Surg. 1989;17(3):116-8.

2. Lauritzen C, Lilja J. Nasolacrimal obstruction in craniofacial surgery. Scand J Plast Reconstr Surg. 1985;19(3):269-72.

3. Serdahl CL, Berris CE, Chole RA. Nasolacrimal duct obstruction after endoscopic sinus surgery. Arch Ophthalmol. 1990;108(3):391-2.

4. Bolger WE, Parsons DS, Mair EA, Kuhn FA. Lacrimal drainage system injury in functional endoscopic sinus surgery. Incidence, analysis, and prevention. Arch Otolaryngol Head Neck Surg. 1992;118(11):1179-84.

5. Tatlisumak E, Aslan A, Cömert A, Ozlugedik S, Acar HI, Tekdemir I. Surgical anatomy of the nasolacrimal duct on the lateral nasal wall as revealed by serial dissections. Anat Sci Int. 2010;85(1):8-12.

6. Unlu HH, Goktan C, Aslan A, Tarhan S. Injury to the lacrimal apparatus after endoscopic sinus surgery: surgical implications from active transport dacryocystography. Otolaryngol Head Neck Surg. 2001;124(3):308-12.

7. Asaumi R, Sato I, Miwa Y, Imura K, Sunohara M, Kawai T, Yosue T. Understanding the formation of maxillary sinus in Japanese human foetuses using cone beam CT. Surg Radiol Anat. 2010;32(8):745-51.

8. McCormick A, Sloan B. The diameter of the nasolacrimal canal measured by computed tomography: gender and racial differences. Clin Experiment Ophthalmol. 2009;37(4):357-61.

9. Moscato EE, Kelly JP, Weiss A. Developmental anatomy of the nasolacrimal duct: implications for congenital obstruction. Ophthalmology. 2010;117(12):2430-4.

10. McDonogh M, Meiring JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol. 1989;103(6):585-7.

11. Kurihashi K, Imada M, Yamashita A. Anatomical analysis of the human lacrimal drainage pathway under an operating microscope. Int Ophthalmol. 1991;15(6):411-6.

12. Lucente FE, Schoenfeld PS. Calibrated approach to endoscopic sinus surgery. Ann Otol Rhinol Laryngol. 1990;99(1):1-4.

13. Unlü HH, Gövsa F, Mutlu C, Yücetürk AV, Senyilmaz Y. Anatomical guidelines for intranasal surgery of the lacrimal drainage system. Rhinology. 1997;35(1):11-5.

14. Tatlisumak E, Aslan A, Cömert A, Ozlugedik S, Acar HI, Tekdemir I Surgical anatomy of the nasolacrimal duct on the lateral nasal wall as revealed by serial dissections. Anat Sci Int. 2010;85(1):8-12.

15. Kim YH, Park MG, Kim GC, Park BS, Kwak HH. Topography of the nasolacrimal duct on the lateral nasal wall in Koreans. Surg Radiol Anat. 2012;34(3):249-55.

16. Linberg JV, Anderson RL, Bumsted RM, Barreras R. Study of intranasal ostium external dacryocystorhinostomy. Arch Ophthalmol. 1982;100(11):1758-62.
Medicine Science-Cover
  • ISSN: 2147-0634
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 2012
  • Yayıncı: Effect Publishing Agency ( EPA )