title: Delayed assessment of the nasolacrimal system at naso-orbito-ethmoid fractures and a modified technique of dacryocystorhinostomy.
abstract: Nineteen patients between 8 and 65 years of age (mean age 32) who were treated for naso-orbito-ethmoid area traumas and suffering from epiphora were evaluated. The time after the trauma was at least 4 months. The patients were divided into two groups. The first group consisted of 10 (52.7%) patients who have undergone a surgical procedure for the fractures before. The second group has 9 (47.3%) members who have never been surgically treated after trauma. All of the patients were evaluated with dacryocystography. Obstruction was found to be in the bony nasolacrimal canal in 13 (68.4%) patients. The nasolacrimal canal was intact in six (31.6%) of the patients. Dacryocystorhinostomy (DCR) was essential for five (50%) of the patients in the first group and eight (88.8%) of the patients in the second group. No additional surgical intervention was carried out for nasal deformities of the patients resulting from naso-orbito-ethmoid fractures. Palpebral malposition was present in six (32%) patients. Relief in tear flow was supplied in all patients. Our aim is to compare the outcomes of a modified technique of DCR and incidence of nasolacrimal system injury in patients with naso-orbito-ethmoid fractures and epiphora on whom reduction was or was not carried out. In conclusion, early surgical reduction of naso-orbito-ethmoid fractures should be performed to prevent problems and deformities of the nasolacrimal system.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Ankara Numune Training and Research Hospital, Ankara, Turkey. uraloglu@hotmail.com
authors.forename: Muhammet
authors.initials: M
authors.lastname: Uraloğlu
authors.forename: Ramazan
authors.initials: R
authors.lastname: Erkin Unlü
authors.forename: Turgut
authors.initials: T
authors.lastname: Ortak
authors.forename: Omer
authors.initials: O
authors.lastname: Sensöz
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003231:Conjunctivitis / Q000209:etiology; D003607:Dacryocystitis / Q000209:etiology; D003608:Dacryocystorhinostomy; D005004:Ethmoid Bone / Q000293:injuries*; D005143:Eyelids / Q000293:injuries; D006801:Humans; D007765:Lacrimal Apparatus / Q000293:injuries* / Q000601:surgery; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis* / Q000601:surgery; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis; D008875:Middle Aged; D009295:Nasal Bone / Q000293:injuries*; D009917:Orbital Fractures / Q000601:surgery*; D011183:Postoperative Complications; D012887:Skull Fractures / Q000601:surgery*; D015607:Stents; D016896:Treatment Outcome