A silastic sheet found during endoscopic transnasal dacryocystorhinostomy for acute dacryocystitis.
OBJECTIVE
To report the case of a silastic sheet that was found during an endoscopic transnasal dacryocystorhinostomy for treatment of acute dacryocystitis with necrosis of the lacrimal sac.


METHODS
A thirty-two year old male presented with painful swelling on the nasal side of his left lower lid two weeks prior to visiting this clinic. Fourteen years ago, the patient was involved in a traffic accident and underwent surgery to reconstruct the ethmoidal sinus. Lacrimal sac massage showed a regurgitation of a purulent discharge from the left lower punctum. Therefore, the patient was diagnosed with acute dacryocystitis and an endoscopic transnasal dacryocystostomy was performed the next day.


RESULTS
The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge. The sheet was removed, the lacrimal sac was irrigated with an antibiotic solution, and a silicone tube was intubated into the lacrimal pathway. After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later.


CONCLUSIONS
We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.
Choi
Jin Seok
JS
Department of Ophthalmology, Gachon Medical School, Gil Medical Center, Inchon, Korea.
Lee
Jong Hyeok
JH
Paik
Hae Jung
HJ
D000328:Adult; D003607:Dacryocystitis / Q000209:etiology* / Q000601:surgery; D003608:Dacryocystorhinostomy / Q000379:methods*; D004129:Dimethylpolysiloxanes / Q000009:adverse effects*; D004724:Endoscopy; D005005:Ethmoid Sinus / Q000293:injuries / Q000601:surgery; D005151:Facial Injuries / Q000601:surgery; D005548:Foreign-Body Migration / Q000150:complications* / Q000601:surgery; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D011475:Prosthesis Failure; D019919:Prosthesis Implantation; D012086:Reoperation; D012828:Silicones / Q000009:adverse effects*
D004129:Dimethylpolysiloxanes; D012828:Silicones; C013830:baysilon