Nasolacrimal injuries are reported to be common and may result in temporary or permanent dysfunction.
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Epidemiology
Fracture of the nasolacrimal apparatus has been reported in ~10% of patients with craniofacial fracture, with ~10% of these reporting symptoms of epiphora or dacryocystitis 1.
Pathology
Injuries may be osseous or soft tissue. The lower canaliculus and/or common canaliculus are the most common part of the nasolacrimal apparatus to be injured with the nasolacrimal duct the second most common part 2.
Etiology
Nasolacrimal injuries can be 1,2:
- traumatic: naso-orbitoethmoid (NOE) fractures (more common) or midface fractures (Le Fort I and II)
-
iatrogenic
- craniofacial surgery: e.g. ORIF, sinus rhinoplasty
- radiation injury: e.g. external beam radiation therapy
- chemotherapy: e.g. 5-fluorouracil
Complications
- dacryocystocele +/- infection 1
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