Morphometric Evaluation of Nasolacrimal Duct

Abstract

Morphometric evaluation of nasolacrimal duct

Abstract

Objectives: Obstructions are very commonly seen in nasolacrimal duct before it opens into the inferior nasal meatus. Detailed anatomical knowledge of the nasolacrimal duct is crucial for physicians to understand the etiology of the obstructions, to plan ideal management option and to reduce unexpected iatrogenic injuries during surgeries. The aim of this study was to investigate morphometric properties of the nasolacrimal duct on computed tomography images. Methods: Three-dimensional computed tomography (3D-CT) of 142 adults (65 females, 77 males) were retrospectively evaluated. Antero-posterior cranial diameter, antero-posterior and transverse diameters and vertical angle of the nasolacrimal duct, distance between distal end of the nasolacrimal duct to anterior surface of the maxilla were measured and the differences evaluated statistically between right and left sides and among females and males and among different ages. All measurements were done using Osirix-Lite version 9 software. Results: None of the morphometric parameters of the nasolacrimal duct showed significant differences between right and left sides. Antero-posterior cranium and transverse diameter of the nasolacrimal duct were longer in men than women. Conclusion: Determining to morphometric properties of the nasolacrimal canal has advantages for understanding the etiology of the NLD obstructions, deciding the ideal surgical technique and reducing to unexpected injuries during surgeries related with this region.

Keywords

• 3D reconstruction
• anatomy
• computed tomography
• nasolacrimal duct

References

1. Lee S, Lee UY, Yang SW, Lee WJ, Kim DH, Youn KH, Kim YS. 3D morphological classification of the nasolacrimal duct: anatomical study for planning treatment of tear drainage obstruction. Clin Anat 2021;34:624–33.
2. Heichel J, Struck HG, Viestenz A, Hammer T, Viestenz A, Fiorentzis M. Anatomic landmarks in lacrimal surgery from an ophthalmologist’s point of view: clinical findings of external dacryocystorhinostomy and dacryoendoscopy. Clin Anat 2017;30:1034–42.
3. Narioka J, Matsuda S, Ohashi Y. Correlation between anthropometric facial features and characteristics of nasolacrimal drainage system in connection to false passage. Clin Exp Ophthalmol 2007; 35:651–6.
4. Valencia MRP, Takahashi Y, Naito M, Nakano T, Ikeda H, Kakizaki H. Lacrimal drainage anatomy in the japanese population. Ann Anat 2019;223:90–9.
5. Czyz CN, Bacon TS, Stacey AW, Cahill EN, Costin BR, Karanfilov BI, Cahill KV. Nasolacrimal system aeration on computed tomographic imaging: sex and age variation. Ophthalmic Plast Reconstr Surg 2016;32:11–6.
6. Ela AS, Cigdem KE, Karagoz Y, Yigit O, Longur ES. Morphometric measurements of bony nasolacrimal canal in children. J Craniofac Surg 2018;29:e282–7.
7. Takahashi Y, Nakamura Y, Nakano T, Asamoto K, Iwaki M, Selva D, Leibovitch I, Kakizaki H. The narrowest part of the bony nasolacrimal canal: an anatomical study. Ophthalmic Plast Reconstr Surg 2013;29:318–22.
8. Okumus O. Investigation of the morphometric features of bony nasolacrimal canal: a cone beam computed tomography study. Folia Morphol (Warsz) 2020;79:588–93.

9. Shigeta K, Takegoshi H, Kikuchi S. Sex and age differences in the bony nasolacrimal canal: an anatomical study. Arch Ophthalmol 2007;125:1677–81.
10. Avdagic E, Phelps PO. Nasolacrimal duct obstruction as an important cause of epiphora. Dis Mon 2020;66:101043.
11. Ali MJ, Schicht M, Paulsen F. Morphology and morphometry of lacrimal drainage system in relation to bony landmarks in caucasian adults: a cadaveric study. Int Ophthalmol 2018;38:2463–9.
12. Elshaarawy EA. Morphological and morphometrical study of the nasal opening of nasolacrimal duct in man. Folia Morphol (Warsz) 2014;73:321–30.
13. Takahashi Y, Kakizaki H, Nakano T. Bony nasolacrimal duct entrance diameter: gender difference in cadaveric study. Ophthal Plast Recons 2011;27:204–5.
14. Park J, Takahashi Y, Nakano T, Asamoto K, Iwaki M, Selva D, Leibovitch I, Yang SW, Kakizaki H. The orientation of the lacrimal fossa to the bony nasolacrimal canal: an anatomical study. Ophthalmic Plast Reconstr Surg 2012;28:463–6.
15. Altun O, Dedeoglu N, Avci M. Examination of nasolacrimal duct morphometry using cone beam computed tomography in patients with unilateral cleft lip/palate. J Craniofac Surg 2017;28:e725–8.
16. Bulbul E, Yazici A, Yanik B, Yazici H, Demirpolat G. Morphometric evaluation of bony nasolacrimal canal in a caucasian population with primary acquired nasolacrimal duct obstruction: a multidetector computed tomography study. Korean J Radiol 2016;17:271–6.
17. Takahashi Y, Nakata K, Miyazaki H, Ichinose A, Kakizaki H. Comparison of bony nasolacrimal canal narrowing with or without primary acquired nasolacrimal duct obstruction in a japanese population. Ophthal Plast Recons 2014;30:434–8.
18. Park JH, Huh JA, Piao JF, Lee H, Baek SH. Measuring nasolacrimal duct volume using computed tomography images in nasolacrimal duct obstruction patients in Korean. Int J Ophthalmol 2019;12:100– 5.
19. Choi SC, Lee S, Choi HS, Jang JW, Kim SJ, Lee JH. Preoperative computed tomography findings for patients with nasolacrimal duct obstruction or stenosis. Korean J Ophthalmol 2016;30:243–50.
20. Zhang C, Yu G, Cui Y, Wu Q, Wei W. Anatomical characterization of the nasolacrimal canal based on computed tomography in children with complex congenital nasolacrimal duct obstruction. J Pediatr Ophthalmol Strabismus 2017;54:238–43.
21. Lin Z, Kamath N, Malik A. High-resolution computed tomography assessment of bony nasolacrimal parameters: variations due to age, sex, and facial features. Orbit 2020;16:1–6.
22. Lee JS, Lee H, Kim JW, Chang M, Park M, Baek S. Association of facial asymmetry and nasal septal deviation in acquired nasolacrimal duct obstruction in East Asians. J Craniofac Surg 2013;24:1544–8.