title: Transection of Nasolacrimal Duct in Endoscopic Medial Maxillectomy: Implication on Epiphora.
abstract: OBJECTIVE
  Management of the nasolacrimal system is usually recommended during medial maxillectomy via external approach because of reported higher rates of postoperative epiphora. Association of the endoscopic medial maxillectomy (EMM) with epiphora, however, is not clearly stated. In this study, we attempted to evaluate whether patients develop epiphora after simple transection of the nasolacrimal duct during EMM.
  
  
  METHODS
  Medical records of 26 patients who underwent endoscopic tumor resection for inverted papilloma (IP) were retrospectively reviewed. Patients who underwent EMM with nasolacrimal canal transection were included and recalled for lacrimal system evaluation. Twelve patients were eligible for inclusion and fluorescein dye disappearance test (FDDT) was performed for each patient. Patient demographics, tumor data, surgical procedures, and follow-up time were recorded.
  
  
  RESULTS
  Of the 12 patients included in the study, 6 underwent canine fossa transantral approach concurrently with EMM. The mean duration of follow-up was 21.1 months (range, 6-84 months). Eight patients were graded as 0, whereas 4 patients were graded as 1 according to FDDT. All test results were interpreted as negative for epiphora. All patients were completely symptom free of epiphora.
  
  
  CONCLUSIONS
  Epiphora after EMM with nasolacrimal canal transection among patients with sinonasal tumors appears to be uncommon. Therefore, prophylactic concurrent management of nasolacrimal system including stenting, dacryocystorhinostomy (DCR), or postoperative lacrimal lavage are not mandatory for all patients.
authors.affiliation: *Department of Otorhinolaryngology †Department of Ophthalmology, Katip Celebi University Ataturk Training and Research Hospital ‡Department of Otorhinolaryngology, Katip Celebi University Medical Faculty §Department of Otorhinolaryngology, Katip Celebi University Ataturk Training and Research Hospital, Izmir, Turkey.
authors.forename: Abdulkadir
authors.initials: A
authors.lastname: Imre
authors.forename: Seher Saritepe
authors.initials: SS
authors.lastname: Imre
authors.forename: Ercan
authors.initials: E
authors.lastname: Pinar
authors.forename: Yilmaz
authors.initials: Y
authors.lastname: Ozkul
authors.forename: Murat
authors.initials: M
authors.lastname: Songu
authors.forename: Ahmet Ata
authors.initials: AA
authors.lastname: Ece
authors.forename: Ibrahim
authors.initials: I
authors.lastname: Aladag
mesh_terms: D000328:Adult; D000368:Aged; D004724:Endoscopy / Q000379:methods*; D005260:Female; D019793:Fluorescein; D005456:Fluorescent Dyes; D005500:Follow-Up Studies; D006801:Humans; D007431:Intraoperative Complications; D007766:Lacrimal Apparatus Diseases / Q000209:etiology*; D008297:Male; D008437:Maxilla / Q000601:surgery*; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000293:injuries*; D009669:Nose Neoplasms / Q000601:surgery; D018308:Papilloma, Inverted / Q000601:surgery; D010255:Paranasal Sinus Neoplasms / Q000601:surgery; D012189:Retrospective Studies; D055815:Young Adult
chemical_list: D005456:Fluorescent Dyes; D019793:Fluorescein