Unexpected pathologies in patients referred for endoscopic DCR

Shani Golan*, Igal Leibovitch, Roee Landsberg

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review


The objective of this study is to describe a series of patients with different pathologies mimicking nasolacrimal duct obstruction (NLDO), diagnosed with the use of a computed tomography (CT) scan prior to a scheduled endoscopic dacryocystorhinostomy (DCR). This study is a retrospective report. We reviewed the medical records of 47 consecutive patients (57 sides) with long-standing epiphora between 2007 and 2012. All patients were referred to our tertiary Medical Center with a diagnosis of NLDO and were expected to undergo endoscopic dacryocystorhinostomy (DCR). They all underwent routine sinus CT scan prior to surgery. All scans, as well as the demographic and medical characteristics of these patients were reviewed. Of all 47 patients enrolled, in 4 patients (7 % of all sides), unexpected pathologies, other than nasolacrimal system distention, inflammation or infection were identified preoperatively. These included squamous cell carcinoma of the lacrimal sac and nasolacrimal duct, rhinoscleroma at Hasner’s valve region, a compressing ethmoidal mucocele and a case of dacryocystocele. These unusual pathologies mandated a different management and surgical approach. In all four cases, a preoperative CT scan helped in identifying the pathology and in localizing the lacrimal apparatus in relation to the paranasal sinuses. Different nasal, paranasal and lacrimal pathologies may mimic primary acquired NLDO. A high index of suspicion, a thorough clinical evaluation and utilizing preoperative imaging may lead to an alteration of patient management and to a completely different surgical approach.

Original languageEnglish
Pages (from-to)3053-3058
Number of pages6
JournalEuropean Archives of Oto-Rhino-Laryngology
Issue number11
StatePublished - Nov 2014
Externally publishedYes


  • Computed tomography (CT)
  • Dacryocystorhinostomy (DCR)
  • Endoscopic DCR
  • Epiphora
  • Nasolacrimal duct obstruction (NLDO)


Dive into the research topics of 'Unexpected pathologies in patients referred for endoscopic DCR'. Together they form a unique fingerprint.

Cite this