泪小管断裂26例手术体会

泪小管断裂有时因伤情复杂鼻侧断端管口寻找困难。为此 ,我们于 1997～ 1999年用直视试探吻合法和切开泪囊开放式置管吻合法治疗泪小管断裂2 6例 ,疗效满意。1　临床资料1 1　一般情况　男 2 5例 ,女 1例 ;年龄 16～ 52岁 ,平均 3 3岁。伤后至就诊 1～ 4 8ｈ ,平均 6ｈ。1 2　手术方法1 2 1　直视试探吻合法　局部清创后对伤口及周围组织予以浸润麻醉 ,首先寻找泪小管鼻侧断端 ,用镊子牵开伤口 ,由于泪小管断端粘膜水肿 ,在创面呈一小白环状 ,如发现鼻侧伤口深部有一乳白色管状断面 ,即插入直式双孔泪道冲洗针 ,注入生理盐水 ,患者感到盐水…     

外伤性泪小管断裂吻合术的探讨

目的:探讨在显微镜下进行外伤性泪小管断裂吻合术的方法及技巧,提高手术成功率.方法:在显微镜下,将断裂的组织进行解剖复位,判断断裂的泪小管鼻侧断端大概位置,在此位置仔细寻找白色"喇叭口"状断端,用平针头注入生理盐水,确认为断端后插入硬膜外导管,将其送入鼻泪管后,逆行插入颞侧端,间断缝合管周组织及皮肤粘膜.术后点抗生素眼水及激素眼水,8～12周左右拔管后每周冲洗两次,并且注入左氧佛沙星凝胶,使得手术成功率明显提高.结果:术后8～12周拔管,其中28例中26例术后冲洗通畅,患者无溢泪症状,1例因泪小管部撕裂再次阻塞.1例因过早拔管而致失败.成功率92.8%.结论:新鲜的外伤性泪小管断裂在显微镜下行吻合手术,术中注意手术技巧,防止泪小管粘膜损伤及撕裂,术后注入左氧佛沙星凝胶,避免粘膜粘连,使得成功率大大提高.     

渔民外伤性泪小管断裂Ⅰ期吻合术体会

目的探讨渔民外伤性泪小管断裂治疗方法。方法在手术显微镜下根据断端离泪点距离、外伤时间、创面肿胀程度及污染情况，采用直接寻找法、逆行寻找法、泪囊切开寻找法，寻找泪小管鼻侧断端，行端端吻合插管修复术。术后用重组牛碱性成纤维细胞生长因子滴眼液（贝复舒）滴眼，1周后用贝复舒、庆大霉素溶液泪道带管冲洗。创面Ⅰ期愈合留硅胶管3个月，Ⅱ期愈合或创面缺损留管4—6个月，最长留管9个月。结果术后随访0．5—2年，治愈32例（76．19％），好转8例（19．05％），无效2例（4．76％）。结论渔民外伤性泪小管断裂采取正确的修复方法和有效的药物治疗，有助于手术成功。     

粘弹剂在下泪小管断裂修复手术断端定位的应用

泪小管断裂(canalicular laceration,CL)是眼科常见的眼创伤之一,约占各种眼睑裂伤的16％[1.眼睑的泪道区域没有睑板和周围结缔组织保护,因此眼睑及面部钝击伤常间接导致泪小管断裂[2-4.如不及时将断裂的泪小管吻合,将会出现永久性溢泪、眼睑畸形愈合、睑外翻等并发症[5.目前,手术显微镜下泪小管吻合术已被认为是修复泪小管断裂的标准方法,通过识别泪小管断端给予精确修复,并放置临时支架,防止愈合过程中瘢痕形成而导致狭窄,达到重建泪小管、恢复泪道通畅的目的[6-7.通常认为在受伤后48h内进行手术吻合效果较好.如何快速准确定位泪小管鼻侧断端是成功吻合泪小管的关键,尤其是当下泪小管断端＞6.5mm时,鼻侧断端常回缩至内眦深部,使得定位更加困难[8-9.临床上寻找泪小管鼻侧断端的方法较多,有直视法、测距法、泪道探针法、猪尾钩法、注液法、泪囊切开法[5,直视法及注液法有一定的局限性,而其他方法可能会不同程度损伤正常组织.粘弹剂为高纯度透明质酸钠和生理缓冲平衡盐组成的无色透明凝胶状溶液,是眼科手术不可缺少的软性手术工具[10.利用粘弹剂(1mL/支,上海其胜生物制剂公司)从上泪小点注入,逆向寻找下泪小管断裂鼻侧断端,操作简单,方便快捷.     

外伤性泪小管断裂吻合术围手术期护理

目的 探讨显微镜下外伤性泪小管断裂吻合术的护理.方法 回顾性总结48例(48眼)外伤性泪小管断裂行泪小管断裂吻合术患者的临床护理资料.结果 48眼中46眼1次手术成功.随诊6个月至1年,46眼治愈,溢泪消失,泪道冲洗通畅;1眼偶有溢泪,泪道冲洗通畅;1例仍不通.48例均无护理并发症发生.结论 外伤性泪小管断裂吻合术可恢复泪液引流系统正常的解剖结构与生理功能,同时使美容缺陷减少到最低限度;而完善的术前准备和心理护理,术后预防感染并重视围手术期护理和出院宣教是提高泪小管断裂术治愈率的关键环节.     

慢性泪囊炎泪囊鼻腔吻合术护理体会

慢性泪囊炎为常见眼病，是泪囊粘膜的卡他性或化脓性炎症。此病多发于成年和老人，女性多于男性。临床表现为泪囊、眦角和结膜囊内有较多黏液性或脓性分泌物。我们对25例28眼慢性泪囊炎进行泪囊鼻腔吻合术，（即泪囊鼻腔造口的手术），在泪囊与鼻腔之间建立新的通道，代替阻塞的鼻泪管以引流泪液，把泪囊和鼻粘膜直接吻合，使分泌物和沮液由泪囊直达中鼻道，使泪道通畅减轻患者痛苦。本组25例患者经泪囊鼻腔吻合术及泪道冲洗护理后无溢泪、溢脓，泪道冲洗通畅，痊愈出院。出院后每周一次冲洗泪道，一月后每月一次复诊，随访6月，患者无溢泪、溢脓症状。现将护理体会介绍如下。     

联合法治疗陈旧性泪小管断离的临床观察

正陈旧性下泪小管断裂是下睑泪小点内侧全层撕裂伤,导致泪小管断离,由于未及时行泪小管断裂再通术,造成患者长期溢泪,引起局部皮肤潮湿糜烂、下睑皮肤粗糙,而影响面部美观~([1])。而吻合术中寻找泪小管的鼻侧断端难度大,2012年9月至2017年10月,笔者应用联合法治疗陈旧性下泪小管断离患者38例,取得了良好疗效,现报道如下。     

医源性泪小管炎误诊为慢性泪囊炎2例

例1，女，64岁。右眼溢泪2年、流脓1年4个月，曾多次就诊于当地医院，均行泪道冲洗，诊断为慢性泪囊炎（右），后来我院就诊，于下泪小点行泪道冲洗见脓性物自下泪小点反流，诊断为慢性泪囊炎（右）。并建议手术。术前检查：于上泪小点冲洗泪道通畅，于下泪小点行泪道冲洗见脓性物自下泪小点反流，下泪小管腔隙增大，触及假道。更正诊断为泪小管炎（右），予庆大霉素8万单位，行下泪小点冲洗泪道，2次／d，克拉霉素0．5g，口服，2次／d，氧氟沙星、舒目眼宝、的确当眼药水点眼治疗。1周后溢泪及流脓症状消失，再次行下泪小点冲洗泪道通畅。     

超声生物显微镜检查定位陈旧性泪小管断裂2例

1 病例报告 例1 患者男，13岁。因左眼下睑外伤后流泪7个月就诊。曾因车祸被撞伤左眼，出现疼痛、出血、流泪症状，于当地医院以“右眼下睑挫裂伤，下泪小管断裂”行下泪小管吻合术，但术中未能找到下泪小管鼻侧断端，吻合失败，仅行眼睑伤口缝合术。此后左眼一直流泪。此次入院眼科检查：右眼视力1．2，左眼1．2。     

脓肿切开引流联合鼻腔泪囊吻合术治疗泪囊脓肿

目的探讨泪囊脓肿的治疗方法。方法回顾分析2011年5月—2012年11月在我院行脓肿切开引流加抗感染治疗后再行鼻腔泪囊吻合术的25例泪囊脓肿患者的临床资料。结果所有病例均在脓肿切开引流后行鼻腔泪囊吻合术,术后无溢泪,冲洗通畅者18例(72.0%);有溢泪,冲洗通畅者4例(16.0%);有溢泪,冲洗不通者3例(12.0%)。结论泪囊脓肿切开引流联合鼻腔泪囊吻合术,是治疗泪囊脓肿合理的方式。     

The clinical value of dacryoscintigraphy in the selection of surgical approach for patients with functional lacrimal duct obstruction

PURPOSE: Dacryoscintigraphy is widely known to be an effective modality in diagnosing abnormalities of the lacrimal system that cause epiphora (pathological overflow of tear). However, dacryoscintigraphy rarely serves beyond the simple diagnostic use for lacrimal duct obstruction. In our study, dacryoscintigraphy results of patients with functional lacrimal duct obstruction are newly classified into three types, the effects and prognoses of silicone tube intubation are noted according to each type, and the role of dacryoscintigraphy in determining appropriate surgical approaches is evaluated. METHODS: Subjects were 36 eyes of 29 patients complaining of epiphora who had increased tear meniscus, but showed no sign of obstruction on duct syringing. Impression of functional lacrimal duct obstruction was made through dacryoscintigraphy, and silicone tubes were inserted. RESULTS: Patients were classified according to the results of dacryoscintigraphy; those with delayed secretion in the distal nasolacrimal duct were typed as class I; those with delays in the proximal nasolacrimal duct class II; and delayed secretion from the pre-lacrimal sac to the lacrimal sac as class III. All patients had silicone tube intubations together with selective punctoplasty. Symptomatic improvement was observed in all 6 cases of distal nasolacrimal duct obstruction (100%), 14 of 18 proximal obstruction cases (77.8%), and 8 of 12 pre-lacrimal obstructions (66.7%). CONCLUSIONS: Functional lacrimal duct obstruction is easily diagnosed with dacryoscintigraphy. Furthermore, its may be classified by types of obstruction to predict post-operative results of silicone tube insertion. Cases suspicious of pre-lacrimal sac obstructions in particular may achieve better operative results with adjuvant treatments in addition to silicone tube insertion.     

综合治疗先天性泪道阻塞133例临床分析

目的：观察综合疗法治疗先天性泪道阻塞的临床疗效。方法选133例147眼先天性泪道阻塞患儿行泪囊按摩,泪道加压冲洗无效即予一体式泪道空心探通针进行泪道探通术,观察治疗的情况进行分析。结果行泪囊按摩方法治愈17只眼,治愈率为11.56%;泪道加压冲洗法治愈25只眼,治愈率17.00%;泪道探通法治愈99只眼,治愈率67.35%;无效6只眼,占4.08%。结论泪囊按摩法和泪道冲洗法治疗新生儿泪道阻塞简单易行有效。泪道探通术是治疗先天性泪道阻塞最有效的方法之一。     

CT of the inferomedial orbit and the lacrimal drainage apparatus: normal and pathologic anatomy

The normal and pathologic CT anatomy of the lacrimal drainage apparatus was examined during study of the orbits, nasal cavity, and paranasal sinuses in 100 patients with a variety of clinical complaints related to the inferomedial orbit. The bony lacrimal fossa, the nasolacrimal canal, and the fluid- or air-filled lacrimal sac and nasolacrimal duct were readily recognized in all cases. The lacrimal fossa and sac are found at the inferomedial orbit and are preseptal structures. Cystic expansion of the lacrimal sac (dacryocystitis) may mimic orbital abscess clinically; however, the radiographic recognition of a cystic, peripherally enhancing mass centered at the lacrimal fossa should exclude postseptal abscess and permit more conservative therapy. Obstruction or invasion of the drainage apparatus by tumor, infection, or posttraumatic scarring is readily depicted by CT. Sagittal/coronal images reformatted from thin transverse axial sections are often useful in defining the origin of an inferomedial orbital mass and its relation to the lacrimal sac when clinical studies and axial CT findings are equivocal.     

Dacryoscintigraphy for the detection of ocular drainage system stenosis induced by docetaxel and fluorouracil

Docetaxel (D) is an antineoplastic agent of the taxane group produced by fir needles and is used in the treatment of breast, lung, prostate, stomach as well as of head and neck cancers. It is usually administered in weekly or 3-weekly regimens. Some side-effects of D are neutropenic fever, anemia, fluid retention, hypersensitivity reactions, anorexia, myalgias, mucositis, mild alopecia, skin and nail toxicity, peripheral neuropathy, canalicular stenosis and/or obstruction, epiphora and tearing. Extensive fibrotic changes in the stroma of the lacrimal sac and the nasal mucosa are the prominent histologic features of the canalicular narrowing and nasolacrimal duct obstruction. Furthermore, studies in patients receiving D treatment showed that after intravenous infusion, D was usually secreted in tears causing ocular irritation. The histologic evidence of keratinization with marked epidermalization of the surface epithelium, thickening, and parakeratosis of the squamous epithelium, confirms fibrosis. Epiphora is a greek word meaning that the line of tears (phora) runs over the eye (epi). Epiphora is a clinical sign or condition, in which tears drain down the face rather than through the nasolacrimal system. Epiphora may also be due to ocular irritation and inflammation or to obstruction of tear outflow tract, ie. ectropion, punctal, canalicular or nasolacrimal obstruction. For punctal stenosis punctoplasty is performed, for subtotal stenosis a permanent silicone tube is advocated and for total stenosis a permanent bypass is required. Dacryoscintigraphy is a well established diagnostic tool for the eye drainage apparatus, and its importance in diagnosing functional lacrimal duct obstruction and even classifying the types of obstruction to predict postoperative results of silicone tube insertion has been reported by others. Chemotherapeutic drugs like D tend to be especially toxic to normal tissues and usually interfere with cell growth or proliferation. Thus, excessive tear production and epiphora, occur as a side effect of D, as the afflicted fibrosis disrupts the continuation of the membranous channel. Although the severity and frequency of epiphora is less with the 3-weekly dosing schedule of D, an incidence of almost 40% has been reported even for this schedule, especially during the longer treatment regimes for metastatic breast cancer. We report on two patients with epiphora and canalicular stenosis developed while on a 3-weekly D treatment regime. Both our patients agreed to be monitored with dacryoscintigraphy. The patients were seated in front of the low energy high resolution (LEHR) collimator of the gamma camera, and after applying 0.1mL of (99m)Tc-pertechnetate of 3.7 MBq on the conjunctiva near the internal canthus of each eyeball we recorded bilateral eyeball images. A dynamic scintigraphy of the area was obtained (9 frames of 1min duration each, followed by one 5min frame, matrix 64x64, LEHR collimator and no zoom), as the (99m)Tc-pertechnetate flows along the tear strips, through the nasolacrimal drainage system, into the nasal fossa. By using LEHR collimator, the canaliculi, the lacrimal sac, the nasolacrimal duct and the Hasner's valve area are normally visualized. When the flow in the lacrimal apparatus is impaired, dacryoscintigraphy will demonstrate the blockage and may also identify the site of obstruction. A follow-up with a second dacryoscintigraphy, a month after the end of D treatment, was performed. The first patient, a 59 years old woman was treated for metastatic breast cancer with D. She received a 3-weekly treatment regime of 75mg/m2 (130 mg in total) intravenously, with dexamethasone coverage for a total of 6 cycles. She reported extensive tearing 2 weeks after the second cycle, which did not improve after discontinuation of the drug. She was advised to use artificial tears and visit the ophthalmology clinic. She had been reluctant to undergo any procedures but at least she agreed to be monitored with dacryoscintigraphy. Initial imaging of the drainage apparatus by dacryoscintigraphy, when symptoms appeared, showed complete bilateral blockage at the lower canaliculus. The second patient, a 54 years old male with metastatic gastric carcinoma received a combination of docetaxel 75 mg/m2 (120mg in total), carboplatin 450mg and 6 pills capecitabine (xeloda) of 500mg each, in a weekly treatment regime (3 weeks treatment and one week intermission), with dexamethasone coverage for a total of 6 cycles. This patient had also refused to visit an ophthalmology clinic but followed our instructions to use artificial tears. The first dacryoscintigraphy was performed as soon as epiphora appeared, a few days after the first cycle of D treatment and the second, a month after the end of 6 cycles of D treatment. Both dacryoscintigraphies, showed a bilateral total blockage of the drainage apparatus in the area of the lower canaliculus. Despite his complaints and discomfort, this patient was also reluctant to undergo any other procedures. Capecitabine is a prodrug converted into fluorouracil (5FU) in the tissues. This combination may increase the possibility of dacryostenosis. The cytotoxic metabolites of 5FU interfere with DNA replication and RNA synthesis in rapidly proliferating tear duct cells and may occasionally cause canalicular stenosis with intractable epiphora and even fibrosis, which is difficult to manage. Furthermore, 5FU is also known to cause mucosal inflammation, conjunctivitis and GI tract inflammations. It may also be hypersecreted from the lacrimal gland, thus tears gaining access over the ocular surface may cause ocular surface toxicity and reflex tearing. The development of cicatricial ectropion further exacerbates the situation. The possibility that the above stenoses could be partly due to viral infection in an immunocompromised patient cannot be excluded. The incidence and severity of lacrimation correlates with the concentration of 5FU in tears but is not directly related to its plasma levels. Epiphora can have a negative impact on the quality of life, because it induces inability to read, drive, put on make up and gives the false impression of emotional tearing. If left untreated, epiphora may have a negative impact on visual function, with significantly lower visual acuity scores. Artificial tears and/or eye drops containing corticosteroids are suggested for treatment. Patients receiving D and/or 5FU should be closely followed by an ophthalmologist for an early diagnosis and treatment of epiphora that may prevent closure of ocular canaliculi. Nuclear dacryoscintigraphy is simple, fast, cheap, and harmless technique for this diagnosis and may replace a more uncomfortable and not so specific technique like the Schirmer's test, in which a filter paper is placed in the lower lid of the eye and the amount of tears is measured. It would be valuable to add the importance of dacryoscintigraphy in the differential diagnosis of pseudoepiphora, which encompasses reflex tearing caused by inflammation or dry eyes, nasal disease, like allergic rhinitis, polyps, tumors or rhinoplasty. It has been suggested that dacryoscintigraphy is the best method for measuring the dynamics of tear drainage especially in the canaliculi, although some prefer the CT dacryocystography, which gives a much higher radiation dose to the patient. In conclusion, we have described one patient with epiphora after docetaxel treatment and another after both docetaxel and 5FU treatment and emphasize the diagnostic value of dacryoscintigraphy.     

螺旋CT在泪道阻塞性疾病诊断中临床应用

目的:探讨螺旋CT在泪道阻塞性疾病诊断中的临床应用价值。方法:搜集86例泪道阻塞病例,分别进行螺旋CT扫描及X线泪道造影。按阻塞位置的检出准确率及并发疾病分别进行统计学分析。结果:76例中单纯泪小管阻塞者11例,CT无法检出,由X线泪道造影检出7例;单纯泪囊阻塞者18例,螺旋CT检出5例,泪道造影检出15例;单纯鼻泪管阻塞者45例,螺旋CT检出41例,泪道造影检出38例;有两种阻塞情况并存的7例,三种阻塞情况并存的5例,均通过二者联合检出。而对其中63例并发其他疾病的检出中,螺旋CT检出为57例,泪道造影为24例。统计学分析,螺旋CT在前两种阻塞情况与泪道造影相比较,差异有显著意义(P<0.05),而在鼻泪管阻塞,二者相比差异无显著意义(P>0.05)。对并发疾病的检出,螺旋CT明显优于泪道造影(P<0.05)。结论:螺旋CT在泪小管及泪囊水平的阻塞检出率较差,而在鼻泪管阻塞的检出率中与泪道造影相近,但在并发疾病的检出率明显高于泪道造影,二者互补检出率则明显提高。     

The value, limitations, and applications of nuclear dacryocystography

Nuclear dacryocystography is simple, relatively harmless method of evaluating patients suspected of having abnormalities of the nasolacrimal drainage system. A group of normal saline containing approximately 100 muCi of 99mTc-pertechnetate is placed on the conjunctiva near the lateral canthus, and serial scintigrams are obtained as the pertechnetate flows along the tear strips, through the nasolacrimal drainage system, into the nasal fossa. By using a pinhole collimator with a very small aperture (1mm), the canaliculi, the nasolacrimal sac, and the nasolacrimal duct are readily visualized. When flow is impaired, the site of obstruction can often be identified. Contrast dacryocystography provides similar information but requires the injection of contrast material directly into a canaliculus. Nuclear dacryocystography provides good functional assessment of nasolacrimal drainage but has serious shortcomings in defining pathologic anatomy. Contrast dacryocystography outlines the anatomy well but often misses minor obstructions. The two studies are complementary and together provide an effective means of evaluating the nasolacrimal drainage system.     

Treatment of nasolacrimal duct obstruction with polyurethane stent placement: long-term results

OBJECTIVE: The purpose of this study was to evaluate the long-term efficacy of polyurethane stent placement in adults with nasolacrimal duct obstruction. SUBJECTS AND METHODS: Polyurethane stents were placed under fluoroscopic guidance in 52 eyes of 49 patients (mean age, 43 years) with severe epiphora due to idiopathic nasolacrimal duct obstruction. The obstruction was complete in 44 eyes and partial in eight. Clinical success was defined as complete resolution of or great improvement in the symptoms of epiphora and the patency of the lacrimal system to irrigation. Mean follow-up was 23 months (range, 14-44 months). RESULTS: Stent placement was technically successful in 50 eyes (96%). The mean fluoroscopy screening time was 2.2 min (range, 0.2-5.8 min). Two patients were lost to follow-up. Clinical success was obtained in 33 (69%) of 48 eyes. Lacrimal symptoms developed in 23 (70%) of these 33 eyes at least once during the follow-up, but these patients responded well to topical drug treatment and lacrimal irrigation. External dacryocystorhinostomy was performed in 13 eyes after failure of the stents. At surgery, lacrimal sacs were shrunken, hyperemic, and fragile in all eyes, making it difficult to anastomose with nasal mucosa. Histologic examination showed granulation tissue and chronic inflammation of the sac epithelium. CONCLUSION: The success rate of the nasolacrimal stent decreases as follow-up lengthens. After stent treatment, lacrimal symptoms frequently develop, even if the stent remains patent, and require multiple office visits and therapy. The polyurethane stent may induce a chronic inflammatory response in the lacrimal sac, which can interfere with subsequent dacryocystorhinostomy.     

Simultaneous dacryocystography and dacryoscintigraphy using SPECT/CT in the diagnosis of nasolacrimal duct obstruction

Epiphora, an abnormal overflow of tears, is commonly caused by tear drainage system anomalies including nasolacrimal duct obstruction. To assess morphologic abnormalities, dacryocystography by CT is used when CT contrast material is syringed into the lacrimal drainage system. To evaluate the function of the system, dacryoscintigraphy is the most readily available noninvasive method. In the case presented, a 43-year-old man was referred to our clinic with an 8 months' history of indefinite left side epiphora. After performing dacryoscintigraphy, we acquired SPECT/CT images during dacryocystography by CT to establish the surgical indication.     

Congenital lacrimal system obstruction: treatment with balloon dilation

PURPOSE: To evaluate the safety and effectiveness of balloon dilation for the treatment of congenital lacrimal system obstruction. MATERIALS AND METHODS: Fluoroscopically guided balloon dilation was attempted in 20 eyes of 16 patients with an age range of 12-78 months (mean, 33 mo) for congenital lacrimal system obstruction. Fifteen eyes had complete obstruction at the valve of Hasner, three eyes had completely obstruction at the junction between the lacrimal sac and the nasolacrimal duct, and two eyes had partial obstruction at the nasolacrimal duct. Under general anesthesia, a ball-tipped guide wire was introduced through the superior punctum into the inferior meatus of the nasal cavity and pulled out through the naris with use of a hook. A deflated 3-mm-diameter balloon catheter was then advanced in a retrograde direction and the balloon was dilated. Every patient underwent an ophthalmic evaluation before the procedure and was scheduled to be followed with office examination at 1, 3, and 6 months after the procedure. RESULTS: There were no major complications. "Technical success" was defined as free passage of contrast medium through the entire lacrimal system to the nasal cavity. The procedure failed in one eye. After balloon dilation, all 19 eyes in which technical success was achieved showed improvement of epiphora. During the follow-up period of 2-33 months (mean, 16 mo), all eyes maintained improvement of epiphora and needed no further treatment. CONCLUSION: Balloon dilation is a safe and effective therapeutic technique for the treatment of congenital lacrimal system obstruction.     

Inverted papilloma originating from the lacrimal sac and the nasolacrimal duct with marked FDG accumulation

Inverted papilloma originating from the lacrimal sac and the nasolacrimal duct is rare, although that in the sinonasal region is a relatively common lesion with local invasion, malignant potential and high recurrence rates after surgery. We report a 52-year-old woman with inverted papilloma of the right lacrimal sac and the nasolacrimal duct, who underwent CT, MR imaging and FDG-PET/CT preoperatively. In addition to CT and MR imaging features similar to those in previous reports, the inverted papilloma exhibited marked FDG accumulation with a maximum standardized uptake value of 7.34 and no other significant FDG accumulation was detected. In summary, our case of inverted papilloma originating from the right lacrimal sac and the nasolacrimal duct noted marked FDG accumulation on PET/CT, which enabled visualization of the localized tumor extension with no metastases.