RESUMO
OBJECTIVE: To evaluate the preoperative tomographic characteristics of the nose and paranasal sinuses of children with chronic dacryocystitis. METHOD: Prospective, observational, cross-sectional, and descriptive study. CT scans of the paranasal sinuses of patients candidates for endoscopic dacryocystorhinostomy were evaluated for two years. Demographic characteristics, radiological findings, inflammatory processes and anatomical variants were identified using the Lund-Mackay classification. Statistic analysis. Stata 10.0, descriptive analysis, Student's t: mean difference and χ2. Logistic studies to estimate the probability between variables. RESULTS: 27 men and 11 women (n = 38) were included. Of these, 22 had unilateral and 16 bilateral nasolacrimal duct involvement. Lund-Mackay score range: 2-20. Eleven patients had associated pathology. The most affected were anterior and maxillary ethmoidal sinus (69%), osteomeatal complex (68%), posterior ethmoidal (51%). Patients with severe rhinosinusitis are 12 times more likely to develop dacryocystitis than patients with < 12 points. Men presented greater severity, affectation, and clinical repercussion. CONCLUSIONS: There is radiological rhinosinusal involvement in dacryocystitis, which must be evaluated and treated preoperatively to avoid postoperative complications or reinfections.
OBJETIVO: Evaluar las características tomográficas preoperatorias de la nariz y los senos paranasales de niños con dacriocistitis crónica. MÉTODO: Estudio prospectivo, observacional, transversal y descriptivo. Se evaluaron tomografías de senos paranasales de pacientes candidatos a dacriocistorrinostomía endoscópica, durante 2 años. Se identificaron características demográficas, hallazgos radiológicos, procesos inflamatorios y variantes anatómicas, utilizando la clasificación Lund-Mackay. Análisis estadístico con Stata 10.0, análisis descriptivo con t de Student: diferencia medias y χ2. Estudios logísticos para estimar la probabilidad entre variables. RESULTADOS: Se incluyeron 27 hombres y 11 mujeres (n = 38). De ellos, 22 tenían afección del conducto nasolagrimal unilateral y 16 bilateral. Rango de puntuación de Lund-Mackay: 2-20. Once pacientes tuvieron patología asociada. Seno etmoidal anterior y maxilar más afectados (69%), complejo osteomeatal (68%), etmoidal posterior (51%). La probabilidad de que los pacientes con rinosinusitis grave puedan presentar dacriocistitis es 12 veces mayor que en los pacientes con < 12 puntos. Los hombres presentaron mayor gravedad, afectación y repercusión clínica. CONCLUSIONES: Existe afección rinosinusal radiológica en la dacriocistitis, que debe ser evaluada y tratada en el preoperatorio para evitar complicaciones o reinfecciones posquirúrgicas.
Assuntos
Dacriocistite , Sinusite , Masculino , Criança , Humanos , Feminino , Estudos Prospectivos , Estudos Transversais , Sinusite/complicações , Sinusite/diagnóstico por imagem , Sinusite/cirurgia , Seio Maxilar/diagnóstico por imagem , Seio Maxilar/cirurgia , Dacriocistite/diagnóstico por imagem , Dacriocistite/cirurgia , Doença CrônicaRESUMO
Acute dacryocystitis retention (ADR) is an unusual entity that contributes to an incorrect diagnosis and treatment. We describe a case of acute dacryocystitis retention occurring in a 61-year-old diabetic male who presented with severe pain, swelling, and inflammatory signs above the left medial canthal ligament tendon. He had no previous history of epiphora. Computed tomography scan indicated acute dacryocystitis. Clinical treatment resulted in complete resolution of the condition. Syringing one month after the acute episode indicated a patent lacrimal excretory system. The temporary obstruction that evolved to an acute dacryocystitis retention was probably secondary to nasal alteration or supposed dacryoliths. Timely, conservative clinical treatment can lead to complete resolution of acute dacryocystitis retention with no further treatments.
Assuntos
Dacriocistite , Dacriocistorinostomia , Doenças do Aparelho Lacrimal , Obstrução dos Ductos Lacrimais , Ducto Nasolacrimal , Dacriocistite/complicações , Dacriocistite/diagnóstico por imagem , Humanos , Doenças do Aparelho Lacrimal/cirurgia , Obstrução dos Ductos Lacrimais/etiologia , Masculino , Pessoa de Meia-Idade , Nariz , Tomografia Computadorizada por Raios XRESUMO
IgG4-related disease (IgG4-RD) is a recently recognized clinical condition with multiple aspects not yet elucidated. It is characterized by a fibrous inflammatory process that involves multiple organs and clinical, serological and histopathological findings, which represent a major challenge for the clinician. Classically described as an expansive tumor lesion with storiform fibrosis, lymphoplasmacytic infiltration (IgG4-positive) and elevated serum IgG4. Clinical features are variable, and pancreatic as well as extrapancreatic involvement has been reported, more frequently in Asian men over 50 years and rarely described in black people. We report the case of an Afro-Colombian teenage woman, who had a unilateral ocular protrusion of unknown cause, with histopathologic findings that revealed infiltration of lymphocyte and plasma cells into the lacrimal gland. It was positive for IgG4, ruling out other conditions, and confirming IgG4-related dacryoadenitis.
Assuntos
Dacriocistite/etiologia , Doença Relacionada a Imunoglobulina G4/complicações , Adolescente , África/etnologia , Azatioprina/uso terapêutico , Biópsia , Colômbia , Dacriocistite/diagnóstico por imagem , Dacriocistite/etnologia , Dacriocistite/patologia , Erros de Diagnóstico , Feminino , Granuloma de Células Plasmáticas/diagnóstico , Humanos , Doença Relacionada a Imunoglobulina G4/etnologia , Aparelho Lacrimal/diagnóstico por imagem , Aparelho Lacrimal/patologia , Linfócitos/patologia , Imageamento por Ressonância Magnética , Plasmócitos/patologia , Prednisona/uso terapêuticoRESUMO
Congenital dacryocystocele is an unusual type of nasolacrimal obstruction. Treatment with antibiotics or surgical removal is practiced to reduce the risks of infection (acute dacryocystitis) and potentially lethal septicemia. Here, we report a case of congenital dacryocystocele, antenatal ultrasonographic diagnosis (intrauterine), and postnatal reassessment.
Assuntos
Dacriocistite/congênito , Dacriocistite/diagnóstico por imagem , Obstrução dos Ductos Lacrimais/congênito , Obstrução dos Ductos Lacrimais/diagnóstico por imagem , Dacriocistite/cirurgia , Dacriocistorinostomia , Feminino , Humanos , Recém-Nascido , Ducto Nasolacrimal/anormalidades , Ducto Nasolacrimal/cirurgia , Tomografia Computadorizada por Raios X , UltrassonografiaAssuntos
Infecções Oportunistas Relacionadas com a AIDS/microbiologia , Dacriocistite/microbiologia , Infecções Oculares Fúngicas/microbiologia , HIV-1 , Paracoccidioides/isolamento & purificação , Paracoccidioidomicose/microbiologia , Infecções Oportunistas Relacionadas com a AIDS/diagnóstico por imagem , Infecções Oportunistas Relacionadas com a AIDS/terapia , Doença Aguda , Anti-Infecciosos/uso terapêutico , Contagem de Linfócito CD4 , Terapia Combinada , Dacriocistite/diagnóstico por imagem , Dacriocistite/terapia , Dacriocistorinostomia , Infecções Oculares Fúngicas/diagnóstico por imagem , Infecções Oculares Fúngicas/terapia , Evolução Fatal , Feminino , Técnica Direta de Fluorescência para Anticorpo , Humanos , Aparelho Lacrimal/microbiologia , Paracoccidioidomicose/diagnóstico por imagem , Paracoccidioidomicose/terapia , RNA/sangue , Radiografia , Combinação Trimetoprima e Sulfametoxazol/uso terapêutico , Carga Viral , Adulto JovemRESUMO
BACKGROUND: After the advent of dacryocystorhinostomy (DCR), dacryocystectomy (DCT) was regarded as mutilant surgery and reserved for lacrimal sac tumors. PURPOSE: To present current indications for dacryocystectomy. METHODS: Eighteen eyes from 11 patients subjected to DCT were reviewed retrospectively. Nine patients had chronic dacryocystitis confirmed by dacryocystography and two patients had lacrimal sac tumors. RESULTS: The indications for DCT were: three patients with systemic medical problems, three patients with dry eye, two cases of lacrimal sac tumors, two cases of traumatic dacryocystitis and one case of cutaneous leishmaniasis. Dacryocystitis was resolved in 17 of 18 eyes; the two cases of tumor evolved without epiphora. One patient (traumatic dacryocystitis) had recurrence of dacryocystitis. CONCLUSIONS: DCT is mainly performed when a lacrimal sac tumor is suspected but, since it avoids the intra- and postoperative complications related to dacryocystorhinostomy, it can be indicated in cases of dacryocystitis with significant lacrimal discharge and an enlarged or altered lacrimal sac.
Assuntos
Dacriocistite/cirurgia , Dacriocistorinostomia/métodos , Neoplasias Oculares/cirurgia , Doenças do Aparelho Lacrimal/cirurgia , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Dacriocistite/diagnóstico por imagem , Dacriocistite/etiologia , Neoplasias Oculares/patologia , Feminino , Humanos , Doenças do Aparelho Lacrimal/patologia , Obstrução dos Ductos Lacrimais/complicações , Masculino , Pessoa de Meia-Idade , Radiografia , Estudos RetrospectivosRESUMO
PURPOSE: This study describes lacrimal tract involvement and surgical outcome in patients with mucocutaneous leishmaniasis. METHODS: Four patients, ages 20 to 75 years, had nasal lesions resulting from mucocutaneous leishmaniasis and sought treatment for chronic dacryocystitis. Each patient had had lacrimal symptoms since childhood or early adulthood, concomitantly with the development of upper airway lesions. Dacryocystography showed nasolacrimal duct stenosis in all cases on the affected side. Three patients underwent dacryocystorhinostomy (one bilaterally), and one patient had bilateral dacryocystectomy. RESULTS: Two patients had surgical fistula closure soon after surgery. A sequential endoscopic operation for remotion of a synechia between the fistula and the middle turbinate was successful in one of these patients. Histopathologic analysis of lacrimal sacs and nasal mucous membranes close to the anastomotic site revealed chronic nonspecific inflammatory process and negative immunohistochemistry for Leishmania. CONCLUSIONS: Dacryocystitis may result from nasal mucocutaneous leishmaniasis. The surgical outcome was unsatisfactory in one of the four patients.
Assuntos
Dacriocistite/etiologia , Leishmaniose Mucocutânea/complicações , Adulto , Idoso , Brasil/epidemiologia , Doença Crônica , Dacriocistite/diagnóstico por imagem , Dacriocistite/epidemiologia , Dacriocistite/cirurgia , Dacriocistorinostomia/métodos , Feminino , Humanos , Incidência , Leishmaniose Mucocutânea/diagnóstico por imagem , Leishmaniose Mucocutânea/epidemiologia , Leishmaniose Mucocutânea/cirurgia , Masculino , Pessoa de Meia-Idade , Ducto Nasolacrimal/diagnóstico por imagem , Ducto Nasolacrimal/cirurgia , Radiografia , Estudos RetrospectivosRESUMO
En un estudio prospectivo realizado entre marzo de 1992 y julio de 1994 se estudiaron ochenta pacientes que tuvieron como denominador común epífora. Se evaluó las bondades de un nuevo método para el estudio de las vías lagrimales que incorporó técnicas de computación permitiendo obtener imágenes digitales libres de elementos óseos (sustracción digital) (AU)