Nasolacrimal duct
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At the time the article was created Henry Knipe had no recorded disclosures.
View Henry Knipe's current disclosuresAt the time the article was last revised Arlene Campos had no financial relationships to ineligible companies to disclose.
View Arlene Campos's current disclosures- Naso-lacrimal duct
- Valve of Krause
- Nasolacrimal duct (NLD)
- Valve of Hasner
- Valve of Taillefer
- Valve of Béraud
- Valve of Huschke
- Valve of Rosenmüller
- Valve of Bochdalek
- Valve of Foltz
- Valve of Cruveilhier
- Valve of Bianchi
The nasolacrimal duct (NLD) is the terminal part of the nasolacrimal apparatus.
Gross anatomy
The nasolacrimal duct is the inferior continuation of the lacrimal sac and is ~17 mm in length in total. The duct runs in the bony nasolacrimal canal. There are two parts to the nasolacrimal duct:
intraosseous part (12 mm): enters the lacrimal groove and descends within the nasolacrimal canal of the maxilla
membranous part (5 mm): runs in the nasal mucosa; terminates below the inferior nasal meatus as a slit-like opening where it is covered by a mucosal fold called the valve of Hasner (or plica lacrimalis)
Valves
Up to eight 'valves' of the nasolacrimal duct have been defined in the literature and are commonly seen in older anatomical texts and monographs. However, it has been contended that some of these are not true mucosal valves but just embryological irregularities in the ductal wall. From craniad to caudad, these 'valves' have been named: Foltz, Bochdalek, Rosenmüller, Huschke, Aubaret, Krause (or Béraud), Taillefer, Hasner (or Cruveilhier/Bianchi) 3,4
The valves of Bochdalek and Foltz are located within the lacrimal puncta, the valves of Rosenmuller and Huschke control the ostium of canaliculi to the lacrimal sac, the valve of Krause guards the path where the lacrimal sac enters the nasolacrimal duct, and the valve of Teileffer is located in the central lacrimal duct 5.
Therefore a retrospective study used digital subtraction dacryocystography (a high spatial resolution technique) to precisely define the intraluminal anatomy of the nasolacrimal duct and determine which of these named structures really represent consistent anatomical features. The researchers used a study group of 92 individuals for whom DS-DCG had previously been reported as normal 3,4:
The inferior group of 'valves' were consistently better seen:
valve of Krause: was visible in 79.3% cases
valve of Taillefer: 93.5% cases
valve of Hasner (plica lacrimalis): 98.9% cases
The superior group of 'valves' were inconsistently visualized and were therefore thought to be mucosal irregularities rather than true anatomical valves:
valve of Foltz and valve of Bochdalek: were visible in 17.1% cases
valve of Rosenmüller and valve of Huschke: 46.4% cases
valve of Aubaret: 40% cases
Related pathology
References
- 1. Russell E, Czervionke L, Huckman M, Daniels D, McLachlan D. CT of the Inferomedial Orbit and the Lacrimal Drainage Apparatus: Normal and Pathologic Anatomy. AJR Am J Roentgenol. 1985;145(6):1147-54. doi:10.2214/ajr.145.6.1147 - Pubmed
- 2. J. Randy Jinkins. Atlas of Neuroradiologic Embryology, Anatomy, and Variants. (2000) ISBN: 9780781716529 - Google Books
- 3. Yedavalli V, Das D, Massoud T. Eponymous "Valves" of the Nasolacrimal Drainage Apparatus. II. Frequency of Visualization on Dacryocystography. Clin Anat. 2019;32(1):35-40. doi:10.1002/ca.23283 - Pubmed
- 4. Yedavalli V, Das D, Massoud T. Eponymous "Valves" of the Nasolacrimal Drainage Apparatus. I. A Historical Review. Clin Anat. 2019;32(1):41-5. doi:10.1002/ca.23284 - Pubmed
- 5. Maliborski A & Różycki R. Diagnostic Imaging of the Nasolacrimal Drainage System. Part I. Radiological Anatomy of Lacrimal Pathways. Physiology of Tear Secretion and Tear Outflow. Med Sci Monit. 2014;20:628-38. doi:10.12659/MSM.890098 - Pubmed
Incoming Links
- Lacrimal sac
- Branchio-oculo-facial syndrome
- Nasolacrimal tumours
- Ocular globe
- Nasolacrimal duct mucocele
- Caldwell-Luc operation
- Dacryocystocele
- Lacrimal apparatus
- Obstruction of nasolacrimal drainage apparatus
- Nasolacrimal drainage apparatus
- Dacryocystography
- Inferior meatus
- Naso-orbitoethmoid region
- Nasal cavity
- Medical abbreviations and acronyms (N)
- Ostiomeatal complex
- Primary acquired nasolacrimal duct obstruction (PANDO)
- Agger nasi cells
- Naso-orbitoethmoid (NOE) complex fracture
- Nasolabial cyst
- Nasolacrimal tube complicated by infection
- Dacryocystitis
- Dacryocystocele
- Osteoma of the ethmoid air cell
- Dacryocystitis
- Dacryocystitis
- Dacryocystitis
- Dacryocystocele
- Lester Jones tube
- Bilateral nasolacrimal duct mucocele and dacryocystocele
- Lacrimal sac adenocarcinoma
- Dacryocystocele
- Macrodacrocystogram - normal (CT)
- Dacryocystitis
- Dacryocystocele - acquired
- Dacryocystogram
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