title: Recurrent dacryocystitis and lacrimocutaneous fistula caused by a retained Griffiths' collar button stent.
abstract: A 42-year-old man presented with a white plastic-like material exposed in the left medial canthal area, with a fistula and purulent discharge. He had undergone endonasal dacryocystorhinostomy 7 years earlier for left eye epiphora; he had persistent postoperative epiphora and recurrent dacryocystitis despite multiple drainage attempts and antibiotics elsewhere. Computed tomography showed bilateral enlarged cystic lacrimal sacs, with a well-defined contoured tunnel-like hole at the center of the left sac. Treatment included excision of the foreign body, which was a Griffiths' collar button nasolacrimal stent, excision of the fistula tract, and revision dacryocystorhinostomy with implantation of bicanalicular silicone stent. He recovered with no further symptoms or complications. This case highlights the importance of follow-up for removal of an implanted Griffiths' stent after dacryocystorhinostomy. Patients with recurrent dacryocystitis may benefit from a detailed history of previous surgery, careful examination, and imaging to evaluate for endogenous and exogenous foreign bodies such as lacrimal sac calculi, and retained lacrimal sac stents.
authors.affiliation: Department of Ophthalmology and.
authors.forename: Arzu Taskiran
authors.initials: AT
authors.lastname: Comez
authors.forename: Oguz
authors.initials: O
authors.lastname: Guclu
authors.forename: Baran
authors.initials: B
authors.lastname: Gencer
authors.forename: Selcuk
authors.initials: S
authors.lastname: Kara
authors.forename: Hasan Ali
authors.initials: HA
authors.lastname: Tufan
mesh_terms: D000328:Adult; D017577:Cutaneous Fistula / Q000000981:diagnostic imaging / Q000209:etiology*; D003607:Dacryocystitis / Q000000981:diagnostic imaging / Q000209:etiology*; D003608:Dacryocystorhinostomy; D006801:Humans; D007440:Intubation / Q000295:instrumentation; D007766:Lacrimal Apparatus Diseases / Q000000981:diagnostic imaging / Q000209:etiology*; D008297:Male; D012008:Recurrence; D015607:Stents / Q000009:adverse effects*; D014057:Tomography, X-Ray Computed