Distal lakrimal kanal tıkanıklığına eşlik eden lateral nazal duvar patolojilerinin incelenmesi

Yıl 2015, Cilt: 5 Sayı: 2, 68 - 71, 14.01.2016

Murat Kaplan Ethem Şahin Ali Okan Gürsel

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

Öz

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. 

Anahtar Kelimeler

Lateral nasal wall pathologies, distal lacrimal duct, obstruction

Kaynakça

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• Please cite this article as: Kaplan M, Şahin E, Gürsel AO. Examination of lateral nasal wall pathologies associated with distal lacrimal duct obstruction.
• ENT Updates 2015;5(2):68–71.