An association between acquired epiphora and the signs and symptoms of chronic rhinosinusitis: a prospective case-control study.
BACKGROUND
It has been suggested that chronic rhinosinusitis may lead to epiphora because of inflammatory edema at the nasal end of the nasolacrimal duct and that treatment of the underlying nasal disease may obviate the need for dacryocystorhinostomy. The aim of this study was to establish whether or not there is an association between the signs and symptoms of chronic rhinosinusitis and a complaint of epiphora in a blinded, prospective case-control study.


METHODS
A consecutive series of 15 adult patients presenting to the ophthalmology department with acquired epiphora were compared with 29 patients presenting with chronic open-angle glaucoma over the same study period. Nasal symptoms and the findings on nasal endoscopy were recorded by a single otolaryngologist blinded to the diagnosis and using a standardized staging system


RESULTS
The age and sex distributions of the two groups were similar. Scores for headache and altered smell were significantly higher in the epiphora cases than in controls (p = 0.05 and 0.03, respectively). Trends for higher scores for congestion and discharge were not statistically significant (p = 0.06 and 0.07, respectively). Mucosal edema and discharge were significantly more common on endoscopy in the epiphora cases than in the control cases (p < 0.02).


CONCLUSIONS
We have shown an association between rhinosinusitis and acquired epiphora, and this would be consistent with chronic rhinosinusitis being the cause of the epiphora in some cases.
Department of Otolaryngology, Ysbyty Gwyned, Bangor, Wales.
Sivakumar
S
Annamalai
N Ajith
NA
Kumar
M B
MB
Madkour
Saraswati
S
Sivakumar
Haytham
H
Kubba
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D002908:Chronic Disease; D004724:Endoscopy; D005260:Female; D005901:Glaucoma / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009296:Nasal Cavity / Q000473:pathology; D009301:Nasolacrimal Duct / Q000473:pathology; D009305:Nasopharynx / Q000473:pathology; D015995:Prevalence; D011446:Prospective Studies; D012220:Rhinitis / Q000453:epidemiology / Q000209:etiology*; D012852:Sinusitis / Q000453:epidemiology / Q000209:etiology*; D013223:Statistics as Topic