title: Traumatic nasolacrimal duct obstruction: clinical profile, management, and outcome.
abstract: OBJECTIVE
  To review clinical profile, management, and outcome in cases of traumatic nasolacrimal duct obstruction (NLDO).
  
  
  METHODS
  A retrospective analysis of 28 patients with the diagnosis of traumatic NLDO during a 12-year period was done. Data regarding nature and pattern of injury, associated damage, clinical features, investigations, management, outcome, and follow-up were reviewed.
  
  
  RESULTS
  Of the 28 patients reviewed in the study, 19 (68%) were male and 9 (32%) were female. Mean age of the patients was 30.1 years. The most common cause of traumatic NLDO was high-velocity blunt injury encountered in road traffic accidents (70%), and the most common pattern of injury was naso-orbito-ethmoidal fractures (64%). Traumatic telecanthus was the most commonly associated periocular injury (54%). Twenty-one patients (75%) were investigated with computed tomography-dacryocystography. A total of 26 patients were treated with external dacryocystorhinostomy with (75%) or without (18%) silicon intubation and 2 (7%) patients underwent dacryocystectomy. General anesthesia was administered in 19 (68%) patients and local anesthesia in 9 (32%) patients. Mean follow-up period was 7.71 months (range 3 months to 6 years). Successful outcome was recorded in 25 out of 26 eyes (96%) operated with external dacryocystorhinostomy with or without silicone intubation.
  
  
  CONCLUSIONS
  Naso-orbito-ethmoidal fracture is the main cause of traumatic NLDO, commonly in young male individuals. Telecanthus is an important presenting feature. Computed tomography-dacryocystography is a useful imaging modality in preoperative assessment and surgical planning. External dacryocystorhinostomy with or without intubation under general anesthesia gives good surgical outcome.
authors.affiliation: Department of Orbit, Oculoplasty, Reconstructive, and Aesthetic Surgery, Medical Research Foundation, Sankara Nethralaya, Chennai, India. beas003@yahoo.co.uk
authors.forename: Bipasha
authors.initials: B
authors.lastname: Mukherjee
authors.forename: Mangesh
authors.initials: M
authors.lastname: Dhobekar
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy; D005151:Facial Injuries / Q000150:complications*; D005260:Female; D050723:Fractures, Bone / Q000150:complications; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000293:injuries* / Q000601:surgery; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D055815:Young Adult