IJAR.2022.205
Type of Article: Original Research
Volume 10; Issue 4 (December 2022)
Page No.: 8469-8475
DOI: https://dx.doi.org/10.16965/ijar.2022.205
A Study on Morphometry and Related Surgical Importance of Naso Lacrimal Duct
Diksha Sharma 1, Anshu Sharma *2, Kanchan Kapoor 3.
1 Demonstrator, Department of Anatomy, Government Medical College and Hospital, Chandigarh, India.
*2 Professor, Department of Anatomy, Government Medical College and Hospital, Chandigarh, India.
3Professor, Department of Anatomy, Government Medical College and Hospital, Chandigarh, India.
Corresponding author: Dr Anshu Sharma, Professor, Department of Anatomy, Government Medical College and Hospital, Chandigarh, India. Mob: 9646121530 E-Mail: anshusharma_01@yahoo.co.in
ABSTRACT
Introduction: The Nasolacrimal duct is the terminal part of the nasolacrimal apparatus or tear apparatus. The anatomy of lateral nasal wall is Important for planning the surgeries on lacrimal duct through intranasal approach.
Objective: The current study was designed to review the anatomy of nasolacrimal duct in relation to the lateral nasal wall.
Material and method: Thirty sagittal sections (14 right and 16 left side) of head and neck of formalin fixed adult cadavers of known sex, gender, ethnicity present in department of anatomy GMCH, Chandigarh were studied. The following parameters were made using a digital calliper and rounded off to the nearest millimetres. 1.Length of nasolacrimal duct (NLD Length) 2. Nearest distance from the nasolacrimal duct to maxillary sinus ostium (NLD – MSO) 3. Nearest distance from the NLD to the anterior nasal spine. (NLD- ANS)4. Nearest distance of the intranasal orifice of the NLD to the nasal floor (NLD- NF) 5. Nearest distance of the intranasal orifice of the NLD to the nasal roof. (NSD- NR) 6. Nearest distance of the intranasal orifice of the NLD to the anterior attachment of the Inferior concha. (NSD- AIT).
Observations: In our study the average length of the NLD was 19.8±1.57mm. The intranasal orifice of the NLD was observed to be located on an average of 24.5±2.6mm from the anterior nasal spine, ranging from 5.5-2. 9mm.The average distance from the nasal roof was found to be 32.2±1.67mm and 16.08±1.71mm from nasal floor. In addition, the average distance from the anterior attachment of inferior nasal concha was found to be 14.82±2.37mm. In our study the NLD was an average of 4.08±0.67mm anterior to MSO at the level of the anterior attachment of the MT. On Comparing right and left side The NLD Was found to be slightly longer 22.7 in comparison of 22.2 mm on left side. The distance of NLD From MSO was also found to be larger on left side. The distances of NLD-ANS, NLD NR, NLD -AIT and NLD- NF were also longer on left side.
Conclusion: We found that most of the parameters were closer to a study done by Ertugel while the NLD-NF distance was more in our specimen.
Key words: Nasolacrimal duct, Maxillary sinus ostium, nasal floor, nasal roof, Anterior attachment of inferior concha.
REFERENCES
[1]. Russel EJ, Czervionke L, Huckman M, Daniels D, MacLachlan D .CT of the inferomedial orbit and the lacrimal drainage apparatus: normal and pathologic anatomy. Am J Roentgenol. 1985;145 (6):1147-54.
[2]. Stranding S, Ellis h, Healy JC, Johnson D, Williams A, Collins P, Wigley C (editors) Gray’s Anatomy. The Anatomical Basis of Clinical Practice. 39th edi: Churchill LIVINGSTONE London2004 pp . 687
[3]. Metson R. surgery. Otolaryngol Head Neck Surg. 1991;104:473–479.
[4]. Lucente FE, Schenfeld. Caliberated approach to endoscopic sinus surgery. Ann Otol Rhinol Laringol. 1990;99(1):1-4.
[5]. McDonogh M, Meiring JH.) Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol. 1989;103:585-587.
[6]. Megan L. Cochran; Sanah Aslam; Craig N. Czyz . Anatomy, Head and Neck, Eye Nasolacrimal Treasure Island (FL): StatPearls Publishing; 2021 Jan.
[7]. Weidenbecher M, Hosemann W, Buhr W. Endoscopic endonasal dacryocystorhinostomy: results in 56 patients. Ann Otol Rhinol Laryngol.1994; 103:363–367,
[8]. Gregg T Lueder. Nasolacrimal Duct Obstruction in children. Am Academy of Ophthalmology. 2015;1-8.
[9]. Kurihashi K, Imada M, Yamashita A. Anatomical analysis of the human lacrimal drainage pathway under operating microscope. Int Ophthal.1991; 15:411–416.
[10]. Thanaviratananich S, Sangsa-Ard S, Tankongchumraskul C, Chaisiwamongkol K. Surgical anatomy of lateral nasal wall in Northeast Thai Cadavers. J Med Assoc Thai. 1996;79:177–184
[11]. Groell R, Schaffler GJ, Uggowitzer M, Szolar DH, Muellner K. CT-anatomy of the nasolacrimal sac and duct. Surg Radiol Anat. 1997;19:189–191.
[12]. Unlu HH, Ozturk F, Mutlu C, Ilker SS, Tarhan S. Endoscopic dacryocystorhinostomy without stents. Auris Nasus Larynx.2000; 27:65–71.
[13]. Wormald PJ, Kew J, Van Hasselt A. Intranasal anatomy of the nasolacrimal sac in endoscopic dacryocystorhinostomy. Otolaryngol Head Neck Surg. 2000;123:307–310.
[14]. Rebeiz EE, Shapshay SM, Bowlds JH, Pankratov MM. Anatomic guidelines for dacryocystorhinostomy. Laryngoscope. 1992; 102:1181–1184.
[15]. Unlu HH, Goktan C, Aslan A, Tarhan S (2001) Injury to the lacrimal apparatus after endoscopic sinus surgery: surgical implications from active transport dacryocystography. Otolaryngol Head Neck Surg. 2001;124:308–312.
[16]. Unlu HH, Caylan R, Kutlu N, Imamoglu M, Unal M, Yuceturk AV . Active transport dacryocystography in evaluating lacrimal drainage system after rhinoplasty. Am J Rhinol.1996;10:87–91.
[17]. Yigit O, Cinar U, Coskun BU, Akgul G, Celik D, Celebi I, Dadas B. The evaluation of the effects of lateral osteotomies on the lateral drainage system after rhinoplasty using active transport dacryocystography. Rhinology.2004; 42:19–22.
[18]. Kim YH, Park MG, Kim GC, et al. Topography of the nasolacrimal duct on the lateral nasal wall in Koreans. Surg Radiol Anat 2012;34(3):249-255.
[19]. Post RH. Tear duct size differences of age, sex and race. Am J Phys Anthropol 1969;30(1):85-88.
[20]. Kennedy DW, Zinreich SJ, Kuhn F et al. Endoscopic middle meatal antrostomy: theory, technique, and patency. Laryngoscope. 1987; 97[Suppl 43]:1–9.
[21]. Serdahl CL, Berris CE, Chole RA. Nasolacrimal duct obstruction after endoscopic sinus surgery. Arch Ophthalmol. 1990; 108(3):391–392.
[22]. Bolger WE, Parsons DS, Mair EA et al. Lacrimal drainage system injury in functional endoscopic sinus surgery. Arch Otolaryngol Head Neck Surg. 1992; 118:1179–1184.
[23]. Calhoun KH, Rotzler WH, Stiernberg CM. Surgical anatomy of the lateral nasal wall. Otolaryngol Head Neck Surg.1990; 102(2):156– 160.
[24]. Wormald PJ. The key to understanding the anatomy of the frontal recess. Otolaryngol Head Neck Surg. 2003;129:497–507
[25]. Sahni SS , Goyal R, Gupta T, Gupta AK.Surgical Anatomy of Nasolacrimal Duct and Sac in Human Cadavers. Clinical Rhinology. 20014; 7(3):91-95
[26]. Ertugrul Tatlisumak, Asım Aslan, Ayhan Comert, Samet Ozlugedik. Surgical anatomy of the nasolacrimal duct on the lateral nasal wall as revealed by serial dissections. Anatomical Science International.2009 may; 85(1):8-12.
