| A Case of Successful Endoscopic Dacryocystorhinostomy in Nasolacrimal Duct Obstruction with Wegener Granulomatosis. |
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Si Hwan Choi, Min Woo Lee, Jong Joo Lee, Sung Bok Lee |
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Department of Ophthalmology, Chungnam National University School of Medicine, Daejeon, Korea. sblee@cnu.ac.kr |
| 베게너 육아종증 환자에서 시행한 성공적인 내시경적눈물주머니코안연결술 |
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최시환⋅이민우⋅이종주⋅이성복 |
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충남대학교 의학전문대학원 안과학교실 |
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Received: 10 April 2015 • Revised: 11 May 2015 • Accepted: 6 July 2015 |
| Abstract |
PURPOSE
To report a case of nasolacrimal duct obstruction occurring in a patient with Wegener granulomatosis treated successfully with endoscopic dacryocystorhinostomy. CASE SUMMARY: A 36-year-old female diagnosed with Wegener's granulomatosis 3 years prior and treated with rituximab and currently taking azathioprine 100 mg presented with a 1-year history of left epiphora and mucus in the left eye. Her left tear meniscus was higher than the right and was a hard stop with lacrimal probe when a lacrimal probing test was performed. Mucus was regurgitated during lacrimal irrigation and middle turbinate was not observed due to granuloma in the nasal cavity. Dacryocystography showed proximal nasolacrimal duct obstruction and a well-defined dacryocystocele 6 x 5 x 6 mm in size was observed on the left lacrimal fossa on facial 3D computed tomography. After synechiolysis for a granuloma in the nasal cavity, endoscopic dacryocystorhinostomy was performed and silastic sheet sutured on the nasal septum to prevent resynechia. After 2 weeks and 4 months, the silastic sheet and silicon tube were removed, respectively. The patient was asymptomatic following surgery and there was no regurgitation during lacrimal irrigation test. The ostium was patent at 5 months after surgery using the endoscopic dye test. CONCLUSIONS: Nasolacrimal duct obstruction occurring in a patient with Wegener's granulomatosis can be treated effectively with endoscopic dacryocystorhinostomy even if the nasal cavity is narrow due to granuloma. |
| Key Words:
Endoscopic dacryocystorhinostomy;External dacryocystorhinostomy;Nasolacrimal duct obstruction;Silastic sheet;Wegener's granulomatosis |
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