CHRONIC DACRYOCYSTITIS

defination: chronic supporative inflammation of lacrimal gland that usually results from obstruction of nasolacrimal duct.

etiology:

It is usually due to stricture of the nasal duct as a result of:

• Chronic inflammation of the nasal mucosa.

• Pressure of nasal polyp

• Hypertrophied inferior turbinate bone.

• Extreme deviation of the nasal septum

organisms involved are pneumococcus staphylococcus streptococcus.

investigations

1. ENT exam

2. probing syringing of lacriamal passage

3. radiological exam

   1. X-ray PNS

   2. dacryocystography

   3. scintigraphy

   4. CT/MRI 

Treatment 

Repeating syringing of the nasolacrimal duct and frequent instillation of antibiotic drops is indicated in recent cases.

in non-responsive cases dacryocystorhinostomy DCR if obstruction is beyond 8mm in canaliculi and 

canaliculo DCR with lester jones tube if obstruction is less than 8 mm in canaliculi

common causes of epiphora

1. Congenital absence of lacrimal puncta.

2. Congenital non-canalization or delayed canalization of nasolacrimal duct.

3. Occlusion of puncta—foreign body, hair, etc.

4. Chronic dacryocystitis with blockage of nasolacrimal duct.

5. Growth or inflammation of inferior meatus.

6. Functional insufficiency for draining the tear in to the nose, e.g. Bell’s palsy, ectropion.