title: Nasolacrimal duct obstruction after maxillary orthognathic surgery.
abstract: OBJECTIVE
  To report cases of nasolacrimal duct obstruction (NLDO) after maxillary orthognathic surgery.
  
  
  METHODS
  The authors reviewed the clinical manifestations, dacryocystographic images, and orbital computed tomographic scans of 10 patients who were diagnosed with NLDO after undergoing maxillary orthognathic surgery.
  
  
  RESULTS
  Six of the 10 patients (60%) complained of epiphora immediately after the surgery. Bilateral (n = 2, 20%) or unilateral (n = 8, 80%) NLDO occurred in all patients involved in the study. Twelve eyes of 10 patients were examined, and dacryocystography showed that the obstruction was present in the distal ostium in 7 eyes (58.3%), the junction between the sac and duct in 3 eyes (25%), and the common canaliculus in 2 eyes (16.7%). Computed tomographic scans of all subjects showed that mucosal swelling and congestion around the distal NLD opening narrowed the space between the lateral nasal wall and the inferior turbinate of the affected side. Dacryocystorhinostomy was performed in 9 eyes (8 patients), with a success rate of 100%.
  
  
  CONCLUSIONS
  The distal to proximal portion of the NLD can become obstructed after maxillary orthognathic surgery. This obstruction seems to be caused by secondary inflammatory changes associated with an indirect injury of the NLD. Therefore, clinicians should be aware of the possibility of NLDO after orthognathic surgery, which can be treated successfully with dacryocystorhinostomy.
authors: Department of Ophthalmology, Soonchunhyang Bucheon Hospital, Soonchunhyang College of Medicine, Bucheon, Korea.
authors: Sun Young
authors: SY
authors: Jang
authors: Min Kyung
authors: MK
authors: Kim
authors: Seok Min
authors: SM
authors: Choi
authors: Jae Woo
authors: JW
authors: Jang
mesh_terms: D000293:Adolescent; D000328:Adult; D003608:Dacryocystorhinostomy; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D008313:Malocclusion, Angle Class III / Q000601:surgery; D008437:Maxilla / Q000601:surgery*; D009301:Nasolacrimal Duct / Q000473:pathology*; D056948:Orthognathic Surgical Procedures / Q000009:adverse effects*; D011378:Prognathism / Q000601:surgery; D014057:Tomography, X-Ray Computed; D055815:Young Adult