title: Recurrent bilateral dacryocystoceles in Wegener's granulomatosis: a rhinologic perspective.
abstract: Wegener's granulomatosis (WG) is a rare, idiopathic, systemic vasculitis of small vessels that manifests in multiple organ systems. Otorhinolaryngic manifestations of this disease include recurrent sinusitis and relapsing polychondritis. Periocular involvement is also a well-documented location of Wegener's disease. We present the case of a 13-year-old girl with severe WG who developed multiple recurrent orbital infections. She underwent multiple incision and drainage surgeries of each orbit and multiple courses of intravenous antibiotics. The patient persistently reaccumulated purulence in her nasolacrimal duct system and was referred to an oculoplastic surgeon for evaluation of these recurrent infections. The diagnosis of dacryocystitis as a complication of WG was made. This unique case represents a patient with severe WG developing bilateral dacryocystitis requiring bilateral dacryocystorhinostomies.
authors.affiliation: Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA.
authors.forename: Benjamin James
authors.initials: BJ
authors.lastname: Westbrook
authors.forename: W Cooper
authors.initials: WC
authors.lastname: Scurry
authors.forename: Donald T
authors.initials: DT
authors.lastname: Hudak
authors.forename: Jonathon
authors.initials: J
authors.lastname: McGinn
authors.forename: Brendan C
authors.initials: BC
authors.lastname: Stack
mesh_terms: D000293:Adolescent; D003607:Dacryocystitis / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D005260:Female; D014890:Granulomatosis with Polyangiitis / Q000150:complications*; D006801:Humans; D009916:Orbital Diseases / Q000000981:diagnostic imaging* / Q000382:microbiology / Q000601:surgery; D012008:Recurrence; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome