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Clinical Note |

Inferior Meatus Dacryolith An Easily Managed Cause of Epiphora

G. Aaron Rogers, MD; John M. DelGaudio, MD
Arch Otolaryngol Head Neck Surg. 2008;134(10):1110-1111. doi:10.1001/archotol.134.10.1110.
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Symptomatic nasolacrimal duct obstruction (NLDO) is a common problem that has the potential to significantly affect the quality of life of many patients. Referral patterns involving patients who are evaluated and often surgically treated without rhinologic examination have developed in most areas. We describe a patient with a diagnosis of NLDO who was found to have a large dacryolith obstructing the nasolacrimal duct orifice on endoscopic examination of the inferior meatus. The dacryolith was easily removed under endoscopic visualization in the office. The patient has had no recurrence of epiphora and was happy to be spared dacryocystorhinostomy (DCR). We believe that cases of NLDO that can be treated by addressing obstruction in the inferior meatus are more common than was previously recognized, and many of these cases undergo more advanced surgical interventions.

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Figure 1.

Endoscopic view of the right inferior meatus demonstrating a large obstructing dacryolith (*). IT indicates inferior turbinate.

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Figure 2.

Gross image of the dacryolith after removal, measuring approximately 8 mm in longest dimension.

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Figure 3.

Endoscopic view of the right inferior meatus 2 weeks after dacryolith removal, demonstrating a well healed nasolacrimal duct opening (*) and showing the anatomical relationship to the inferior turbinate (IT).

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