title: Endoscopic ultrasonic dacryocystorhinostomy for recurrent dacryocystitis following rhinoplasty.
abstract: The lacrimal sac is the structure most vulnerable to injury when performing rhinoplastic osteotomies. When performed in a low lateral position or along the frontal process of the frontal-maxillary suture, osteotomies can potentially tear the medial canthal tendon and injure the underlying lacrimal sac, possibly resulting in dacryocystitis. In this case report, the authors discuss a case of dacryocystitis following primary rhinoplasty; this injury was repaired with endoscopic dacryocystorhinostomy (DCR) using a Sonopet ultrasonic bone aspirator (Stryker, Kalamazoo, Michigan) at a single institution. This method achieved nasolacrimal duct patency, and the patient continued to be symptom-free at an 18-month follow-up. This is the first reported case of recurrent dacryocystitis following rhinoplasty as treated by endoscopic DCR.
  
  
  METHODS
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authors.affiliation: Dr Mostovych and Dr Rabinowitz are Residents and Dr Pribitkin is a Professor in the Department of Otolaryngology-Head & Neck Surgery, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania.
authors.forename: Nadia K
authors.initials: NK
authors.lastname: Mostovych
authors.forename: Mindy R
authors.initials: MR
authors.lastname: Rabinowitz
authors.forename: Jurij R
authors.initials: JR
authors.lastname: Bilyk
authors.forename: Edmund A
authors.initials: EA
authors.lastname: Pribitkin
mesh_terms: D003607:Dacryocystitis / Q000175:diagnosis / Q000209:etiology / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000379:methods*; D019160:Endosonography; D006801:Humans; D008297:Male; D012008:Recurrence; D012086:Reoperation; D012225:Rhinoplasty / Q000009:adverse effects*; D025321:Surgery, Computer-Assisted; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
keywords: computer topography (CT); dacryocystitis; endoscopic dacryocystorhinostomy (eDCR); epiphora; imaging guidance; lacrimal drainage system (LDS); lacrimal sac; lacrimal sac injury; rhinoplasty; ultrasonic bone aspirator (UBA)