Introduction: The formation of a fistula between the lacrimal sac and the skin is a classic outcome of resistant lacrimal sac abscesses. There is currently no consensus about treatment in such cases. The goal of this study was to describe the natural history of acquired fistulas between the lacrimal sac and the skin, occurring before planned endonasal dacryocystorhinostomy (DCR) and without any treatment of the fistula.
Materials And Methods: This prospective study was only descriptive and included patients between 1999 and 2012. The patients included were adults with a nasolacrimal duct (NLD) obstruction that was planned to be treated with endonasal DCR. A resistant lacrimal sac abscess appeared a few days before the planned surgery, and fistulized spontaneously despite medical treatment. The surgery was not delayed. The DCR was endoscopic. Nothing was done for the fistula. Its healing was spontaneous. The exclusion criteria were the following: congenital fistulas, post-traumatic and/or iatrogenic fistulas, fistulas which had regressed by the day of the surgery, postoperative follow-up less than 5 months, post-traumatic and/or iatrogenic fistulas, any history of previous DCR or any other lacrimal surgery, children.
Results: Twenty adults (25 cases) were included in the analysis. Mean age was 79 years old (from 41 to 90). The mean follow-up was 41 months (from 5 to 108 months). The fistula spontaneously disappeared in all cases, less than one month after it had appeared and in a permanent fashion. No unsightly scar developed.
Discussion: Spontaneously acquired fistulas between the lacrimal sac and the skin may occur in the natural course of abscessed acute dacryocystitis. Our study showed spontaneous healing of the fistula post-endoscopic DCR.
Conclusion: Fistula excision in fistulous acute dacryocystitis does not seem essential to its healing. The laisser-faire approach appears adequate for aesthetic outcomes as well as for functional outcomes of DCR.
Download full-text PDF |
Source |
|---|---|
| http://dx.doi.org/10.1016/j.jfo.2016.03.009 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
Understanding the Spectrum of Mild Clinical Outcomes and Novel Findings in Arterial Tortuosity Syndrome Among Qatari Patients: Implications of SLC2A10 Mutation.
Biomedicines
January 2025
Translational Research Institute, Academic Health System, Hamad Medical Corporation, Doha 3050, Qatar.
/: Arterial Tortuosity Syndrome (ATS) is a rare, autosomal recessive connective tissue disorder characterized by arterial twists, abnormal bulges, constriction, and tears. Patients have distinctive features and disease manifestations. The syndrome's full clinical spectrum and course remain incompletely understood.
View Article and Find Full Text PDFOrbital and adnexal sarcoidosis: Clinical presentations and management outcomes.
Indian J Ophthalmol
February 2025
Department of Orbit, Oculoplasty, Reconstructive and Aesthetic Services, Sankara Nethralaya, Medical Research Foundation, Chennai, Tamil Nadu, India.
Purpose: To present the clinical features and management outcomes in a series of patients with orbital and adnexal sarcoidosis.
Methods: This was a retrospective analysis of 19 histopathologically proven cases of orbital and adnexal sarcoidosis over the past ten years. The data analyzed included demographic details, clinical and imaging features, and management outcomes.
Application of S-100 absorbable hemostatic patch in endonasal endoscopic dacryocystorhinostomy: A randomized controlled trial.
Indian J Ophthalmol
February 2025
Hainan Eye Hospital and Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Haikou, Hainan Province, China.
Purpose: To investigate the effect of S-100 absorbable hemostatic patch coverage on anastomotic mucosa in endonasal endoscopic dacryocystorhinostomy (En-DCR).
Methods: Two hundred and twenty-six patients with unilateral chronic dacryocystitis (CD) were randomly divided into two groups in a randomized controlled trial: the S-100 absorbable hemostatic patch group (group A) and the control group (group B). All patients underwent En-DCR.
Immediate Stentless Lacrimal Sac to Conjunctiva Reconstructive Ostomy for Cancer and Trauma Defects: LACROS (Conjunctivodacryocystostomy).
Ophthalmic Plast Reconstr Surg
January 2025
Plastic Surgery Unit, Clínica San Francisco, Tuluá, Colombia.
Purpose: To describe and evaluate the efficacy and safety of lacrimal sac to conjunctiva reconstructive ostomy for proximal lacrimal system reconstruction.
Methods: This retrospective study included 41 patients (32 cancer and 9 trauma; 36 primary and 5 secondary) who underwent lacrimal sac to conjunctiva reconstructive ostomy. The technique involves creating a direct connection between a surgical opening in the lacrimal sac, which maintains its bony attachments to prevent ostomy occlusion, and the medial conjunctiva (medial fornix, bulbar, and palpebral).
Lacrimal Sac CLL: A Review of Clinical Features, Investigations, and Management.
Ophthalmic Plast Reconstr Surg
January 2025
Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom.
Purpose: This study reviews all reported cases of lacrimal gland chronic lymphocytic leukemia (CLL) to identify patterns in clinical presentation, diagnosis, and management to aid in early recognition and treatment of this uncommon occurrence.
Methods: A comprehensive search of medical literature databases was performed to identify studies reporting lacrimal sac involvement in CLL from 1970 to 2024. Data were extracted regarding demographics, symptoms, diagnostic methods, treatment, and outcomes.
Want AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!