Avoiding dacryocystorhinostomy in cases of epiphora caused by inferior meatus obstruction

Dvir Koenigstein*, Ran Ben Cnaan, Shay Keren, Igal Leibovitch, Ahmad Safadi, Roee Landsberg, Avraham Abergel

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Aims: To determine the role of inferior meatus pathologies as an underdiagnosed cause of epiphora. Methods: This study was conducted in the oculoplastic institution of Tel Aviv medical center—a regional referral center. A retrospective review of files of patients presenting to the lacrimal clinic with nasolacrimal duct obstruction between October 2010 and September 2016. Cases in which a pathology of the inferior meatus was identified and treated are presented in this article. Results: During this time frame, we preformed 186 endoscopic dacryocystorhinostomy surgeries. Out of those, eight patients (4.3%) were diagnosed and treated for pathology causing an obstruction of the inferior meatus. Seven of our patients were females; the mean age was 24 years. A wide range of pathologies were found: cysts, dacryoliths, membranes obstructing the inferior meatus, and concheal obstruction. All patients went through endoscopic treatment targeted at the cause of obstruction. During follow-up (average 35 months) only two patients remained symptomatic and were referred for an endonasal endoscopic dacryocystorhinostomy. Conclusions: Inferior meatus obstruction is an underdiagnosed cause of epiphora. Multiple pathologies may co-exist in the same patient. In select cases of NLDO, diagnosis and treatment can be done endoscopically, avoiding the need for dacryocystorhinostomy.

Original languageEnglish
Pages (from-to)1406-1410
Number of pages5
Issue number8
StatePublished - 1 Aug 2018


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