Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography research
AIM: To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy (EN-DCR). METHODS: This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 8...
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Press of International Journal of Ophthalmology (IJO PRESS)
2025-02-01
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| Series: | International Journal of Ophthalmology |
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| Online Access: | http://ies.ijo.cn/en_publish/2025/2/20250208.pdf |
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| author | Xin-Han Cui Yan-Wen Fang Li-Min Zhang Ji-Ni Qiu Chao-Ran Zhang Yan Wang |
| author_facet | Xin-Han Cui Yan-Wen Fang Li-Min Zhang Ji-Ni Qiu Chao-Ran Zhang Yan Wang |
| author_sort | Xin-Han Cui |
| collection | DOAJ |
| description | AIM: To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy (EN-DCR). METHODS: This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients. Computed tomographic-dacryocystography (CT-DCG) scans were performed before lacrimal surgery, and image reconstruction was used to obtain continuous 0.75-mm axial, coronal, and segmental sections for review. The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement, as well as the obstructed location. RESULTS: The height of the lacrimal sac was 12.99±2.10 mm in this study. The operculum of the middle turbinate (OMT) was located vertically in the lower third of the lacrimal sac. Horizontally, the junction between the maxillary bone and the lacrimal bone (MB-LB) was close to, mostly (60.2%) posterior to, the lacrimal sac. The uncinate process was more frequently attached to the lacrimal bones (75.1%). The obstructions were generally located around the entrance of the nasolacrimal duct (NLD). However, some were placed higher, with 7.63% blocked not lower than the OMT. There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction (r= -0.35, P<0.01). CONCLUSION: In this study, the OMT and MB-LB can be served as the landmarks in EN-DCR. Partial uncinectomy should be performed in most cases. The obstructions were generally located around the entrance of the NLD, but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery. |
| format | Article |
| id | doaj-art-7830d6cabb2747d18a5976bd789cf6e3 |
| institution | Kabale University |
| issn | 2222-3959 2227-4898 |
| language | English |
| publishDate | 2025-02-01 |
| publisher | Press of International Journal of Ophthalmology (IJO PRESS) |
| record_format | Article |
| series | International Journal of Ophthalmology |
| spelling | doaj-art-7830d6cabb2747d18a5976bd789cf6e32025-01-16T07:54:35ZengPress of International Journal of Ophthalmology (IJO PRESS)International Journal of Ophthalmology2222-39592227-48982025-02-0118225125710.18240/ijo.2025.02.0820250208Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography researchXin-Han Cui0Yan-Wen Fang1Li-Min Zhang2Ji-Ni Qiu3Chao-Ran Zhang4Yan Wang5Yan Wang and Chao-Ran Zhang. Eye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, No.83 Fenyang Road, Shanghai 200031, China. wangyandoc@163.com; zhangchaoran@hotmail.comEye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China; NHC Key laboratory of Myopia and Related Eye Diseases; Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai 200031, ChinaShanghai Key Laboratory of Visual Impairment and Restoration, Shanghai 200031, ChinaEye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China; NHC Key laboratory of Myopia and Related Eye Diseases; Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai 200031, ChinaEye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China; NHC Key laboratory of Myopia and Related Eye Diseases; Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai 200031, ChinaEye Institute and Department of Ophthalmology, Eye and ENT Hospital of Fudan University, Shanghai 200031, China; NHC Key laboratory of Myopia and Related Eye Diseases; Key Laboratory of Myopia and Related Eye Diseases, Chinese Academy of Medical Sciences, Shanghai 200031, ChinaAIM: To describe the anatomic characteristics of the lacrimal sac and its adjacent bone structures and to provide surgical recommendations for endoscopic dacryocystorhinostomy (EN-DCR). METHODS: This retrospective comparative study involved 118 sides with complete nasolacrimal duct obstruction and 83 unaffected sides from 126 patients. Computed tomographic-dacryocystography (CT-DCG) scans were performed before lacrimal surgery, and image reconstruction was used to obtain continuous 0.75-mm axial, coronal, and segmental sections for review. The morphology of the lacrimal sac and its relationship with adjacent bony structures were determined for measurement, as well as the obstructed location. RESULTS: The height of the lacrimal sac was 12.99±2.10 mm in this study. The operculum of the middle turbinate (OMT) was located vertically in the lower third of the lacrimal sac. Horizontally, the junction between the maxillary bone and the lacrimal bone (MB-LB) was close to, mostly (60.2%) posterior to, the lacrimal sac. The uncinate process was more frequently attached to the lacrimal bones (75.1%). The obstructions were generally located around the entrance of the nasolacrimal duct (NLD). However, some were placed higher, with 7.63% blocked not lower than the OMT. There was a negative correlation between the diameter of the lacrimal sac and the level of obstruction (r= -0.35, P<0.01). CONCLUSION: In this study, the OMT and MB-LB can be served as the landmarks in EN-DCR. Partial uncinectomy should be performed in most cases. The obstructions were generally located around the entrance of the NLD, but some extreme individual variations strongly implies the importance of CT-DCG scanning before surgery.http://ies.ijo.cn/en_publish/2025/2/20250208.pdflacrimal sacnasolacrimal duct obstructionendoscopic dacryocystorhinostomycomputed tomographic-dacryocystography |
| spellingShingle | Xin-Han Cui Yan-Wen Fang Li-Min Zhang Ji-Ni Qiu Chao-Ran Zhang Yan Wang Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography research International Journal of Ophthalmology lacrimal sac nasolacrimal duct obstruction endoscopic dacryocystorhinostomy computed tomographic-dacryocystography |
| title | Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography research |
| title_full | Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography research |
| title_fullStr | Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography research |
| title_full_unstemmed | Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography research |
| title_short | Anatomic characteristics of the lacrimal sac and adjacent bony structures–a computed tomographic-dacryocystography research |
| title_sort | anatomic characteristics of the lacrimal sac and adjacent bony structures a computed tomographic dacryocystography research |
| topic | lacrimal sac nasolacrimal duct obstruction endoscopic dacryocystorhinostomy computed tomographic-dacryocystography |
| url | http://ies.ijo.cn/en_publish/2025/2/20250208.pdf |
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