Distal lakrimal kanal tıkanıklığına eşlik eden lateral nazal duvar patolojilerinin incelenmesi

Öz

Amaç: Bu çal›flmada lateral nazal duvar ve sinüs patolojilerinin distal lakrimal kanal t›kan›kl›¤› etiyolojisindeki rolü araflt›r›lm›flt›r. Yöntem: Nisan 1999 ile Eylül 2003 tarihleri aras›nda endoskopik endonazal dakriosistorinostomi ve silikon entübasyonu planlanan 17 kad›n ve 11 erkek hasta çal›flmaya dahil edildi. Hastalar›n lakrimal kanal t›kan›kl›¤› tan›s› için göz kliniklerinde Schirmer testi, flöresein boya kaybolma testi, Jones I-II testleri, kanaliküler irrigasyon, kanaliküler problama, dakriosistografi, dakriosintigrafi gibi genel oftalmolojik muayeneleri yap›ld›. KBB kliniklerinde nazal kavite patolojileri için anterior rinoskopi ve diagnostik nazal endoskopik muayeneleri yap›ld›. Tüm hastalarda paranazal bilgisayarl› tomografi ile ostiomeatal kompleks hastal›¤›, etmoid hücre opasifikasyonu, konka bülloza, agger nazi hücresi varl›¤› de¤erlendirilerek 50 kontrol olgusundaki bulgular ile Fisher’in ki-kare testiyle karfl›laflt›r›ld›. Bulgular: Lakrimal kanal t›kan›kl›¤›n oldu¤u tarafta agger nazi hücresi 17 (%60.7), konka bülloza 10 (%35.7), etmoid hücre opasifikasyonu 6 (%21.4), osteomeatal kompleks hastal›¤› 4 (%14.2), bir veya daha fazla bulgu 21 (%75) hastada saptand›. Bu lateral nazal duvar ve sinüs patolojileri çal›flma grubunda kontrol grubuna oranla yüksek bulunmas›na karfl›l›k istatistiksel olarak anlaml› bulunmad› (p>0.05). Sonuç: Lateral nazal duvar ve sinüs patolojilerini distal nazolakrimal sistem t›kan›kl›¤› olan hastalarda yüksek oranda bulmam›za ra¤men etiyolojisini aç›klamakta yetersiz oldu¤u ve paranazal bilgisayarl› tomografinin bu hastalar›n de¤erlendirilmesinde artan öneme sahip olaca¤› kan›s›na vard›k. 

Anahtar Kelimeler

• Lateral nazal duvar patolojileri, distal lakrimalkanal, tıkanıklık

Examination of lateral nasal wall pathologies associated with distal lacrimal duct obstruction

Abstract

Objective: In this study, the role of lateral nasal wall and sinus pathologies in the etiology of distal lacrimal duct disease has been investigated. Methods: Seventeen female and 11 male patients who were scheduled for endoscopic endonasal dacryocystorhinostomy and silicon tube intubation between April 1999 and September 2003 were included in the study. The patients underwent general ophthalmologic examinations such as Schirmer test, fluorescein dye disappearance test, Jones I-II tests, canalicular irrigation, canalicular probing, dacryocystography, dacryoscintigraphy for the diagnosis of lacrimal duct obstruction. In the clinics of ENT, for the detection of nasal cavity pathologies, anterior rhinoscopy and diagnostic nasal endoscopic examinations were performed. All patients were evaluated during paranasal computed tomographic examinations regarding osteomeatal complex disease, ethmoid cell opacification, concha bullosa and presence of agger nasi cells and data obtained were compared with findings of 50 control subjects using Fisher’s chi-square tests. Results: On the side where lacrimal duct obstruction exists, agger nasi cells were detected in 17 (60.7%) patients, concha bullosa in 10 (35.7%) patients, ethmoid cell opacification in 6 (21.4%) patients, osteomeatal complex disease in 4 (14.2%) patients, and one or more than one symptom were detected in 21 (75%) patients. Despite higher number of lateral nasal wall and sinus pathologies in the study group when compared with the control group, intergroup difference was not statistically significant (p>0.05). Conclusion: We have concluded that despite the higher rates of lateral nasal wall and sinus pathologies in patients with distal nasolacrimal system obstruction, its etiology has not been adequately expounded and paranasal computed tomographies will have increasing importance in the evaluation of these patients. 

Keywords

• Lateral nasal wall pathologies,distal lacrimal duct,obstruction

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26. Please cite this article as: Kaplan M, Şahin E, Gürsel AO. Examination of lateral nasal wall pathologies associated with distal lacrimal duct obstruction.
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