Agger nasi cell mucosal autograft for lacrimal sac reconstruction during endonasal dacryocystorhinostomy.
A mucosal autograft composed of agger nasi cell mucosa was used to reconstruct the lacrimal sac mucosa in a young woman with a cicatrised lacrimal sac and obstructed nasolacrimal system. The patient had undergone a previous external dacryocystorhinostomy (DCR), dacryocystectomy and revision mechanical endonasal DCR. There was persistent epiphora and at further mechanical endonasal (MEN) DCR it was noted that only a small cuff of lacrimal sac mucosa around the common canaliculus was present. To achieve a mucosal anastomosis, the agger nasi cell mucosa was removed from the cell and placed as a free mucosal graft around the common canalicular opening. Apposition with the nasal mucosa was completed with flaps from the lateral nasal wall mucosa. Postoperatively, the patient is asymptomatic with a freely draining ostium at 18 months of follow-up.
Tsirbas
Angelo
A
Department of Ophthalmology, Flinders Medical Centre and Queen Elizabeth Hospital, Adelaide, South Australia. opthamology@fmc.sa.gov.au
Wormald
Peter
P
D000328:Adult; D017690:Cell Transplantation; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007765:Lacrimal Apparatus / Q000601:surgery*; D009297:Nasal Mucosa / Q000166:cytology / Q000637:transplantation*; D019651:Plastic Surgery Procedures; D013524:Surgical Flaps; D014182:Transplantation, Autologous