Management of congenital lacrimal fistula combined with eyelid cosmetic surgery / 中华医学美学美容杂志

Objective:To investigate the feasibility and availability of one-stage treatment for congenital lacrimal fistula combined with blepharoplasty and epicanthoplasty.Methods:From November 2014 to March 2021, 6 female patients with congenital lacrimal fistula and epicanthus were treated in the 2nd Department of Maxillofacial Plastic Surgery Hospital, Chinese Academy of Medical Sciences/Peking Union Medical College, aged 12-32 years (mean 24 years), including 5 unilateral lacrimal fistula and 1 bilateral.Results:During 3 to 40 months (mean 18 months) of follow-up, the ocular appearances were improved notably and the fistulas were removed completely. There was no secondary infection or cyst occurred, and no ectropion, traction or other deformities. The position of canthus was normal and the shape of canthus was good. The scars in the operation area were inconspicuous.Conclusions:Fistulectomy combined with blepharoplasty and epicanthoplasty can excise congenital lacrimal fistula effectively while improving the ocular appearance by this procedure.

Bilateral congenital lacrimal fistulas in an adult as part of ectrodactyly-ectodermal dysplasia-clefting syndrome: A rare anomaly.

Ectrodactyly‑ectodermal dysplasia and clefting syndrome or “Lobster claw” deformity is a rare congenital anomaly that affects tissues of ectodermal and mesodermal origin. Nasolacrimal duct (NLD) obstruction with or without atresia of lacrimal passage is a common finding of such a syndrome. The authors report here even a rarer presentation of the syndrome which manifested as bilateral NLD obstruction and lacrimal fistula along with cleft lip and palate, syndactyly affecting all four limbs, mild mental retardation, otitis media, and sinusitis. Lacrimal duct obstruction and fistula were managed successfully with endoscopic dacryocystorhinostomy (DCR) which is a good alternative to lacrimal probing or open DCR in such a case.

Efficacy analysis of lacrimal fistula excision combined double silicone intubation in the treatment of chronic dacryocystitis with lacrimal fistula / 国际眼科杂志(Guoji Yanke Zazhi)

?AlM:To observe the clinical effects of thelacrimal fistula excision combined with double silicone intubation in the treatment of chronic dacryocystitis with lacrimal fistula.? METHODS: Totally 25 cases ( 25 eyes ) of chronic dacryocystitis with lacrimal fistula were allocated into two groups:the double silicone intubation group of 13 cases (13 eyes) received lacrimal fistula excision combined with double silicone intubation, and the routine group of 12 cases (12 eyes) received routine dacryocystorhinotomy, we analyzed the curative effect.?RESULTS: The double silicone intubation group had a cure rate of 92. 3% (12 eyes), a effective rate of 100%, compared with the routine group had a cure rate of 91. 7%( 11 eyes ) , a effective rate of 100%, there were no statistically significant difference between the two groups (P>0. 05).?CONCLUSlON:Lacrimal fistula excision combined with double silicone intubation has a same effect with routine dacryocystorhinotomy in the treatment of chronic dacryocystitis with lacrimal fistula, but less invasive, no scar, less pain, and meet the patients' esthetic needs.

A Case of Acquired Lacrimal Fistula Caused by Silicone Tube Remnant

PURPOSE: To report a case of acquired lacrimal fistula caused by silicone tube remnant. CASE SUMMARY: A 56-years-old female who suffered from purulent discharge in inner skin of the right lower eyelid visited our clinic. Lacrimal fistula was found in the skin at the medial side of the right lower eyelid. The patient reported that she had a silicone tube intubation operation 3 years prior due to a nasolacrimal obstruction of right eye. On syringing test, saline solution and purulent discharge were drained from the fistula skin opening and there was no nasolacrimal obstruction. After admission, antibiotic treatment and potadine soaking dressing were performed to facilitate spontaneous closing of the lacrimal fistula. However, the lacrimal fistula relapsed and lacrimal fistulectomy and bicanalicular silicone tube intubation were performed. During surgery, silicone tube remnant material not totally extubated at the lacrimal sac was found which we removed. Postoperatively, systemic antibiotic therapy was administered and the chronic inflammation improved. CONCLUSIONS: We report a case of lacrimal fistula caused by silicone tube remnant in the lacrimal sac. Acquired lacrimal fistula caused by a silicone tube remnant can be treated by fistulectomy and silicone tube remnant removal.

A Case of Acquired Lacrimal Fistula Caused by Silicone Tube Remnant

PURPOSE: To report a case of acquired lacrimal fistula caused by silicone tube remnant. CASE SUMMARY: A 56-years-old female who suffered from purulent discharge in inner skin of the right lower eyelid visited our clinic. Lacrimal fistula was found in the skin at the medial side of the right lower eyelid. The patient reported that she had a silicone tube intubation operation 3 years prior due to a nasolacrimal obstruction of right eye. On syringing test, saline solution and purulent discharge were drained from the fistula skin opening and there was no nasolacrimal obstruction. After admission, antibiotic treatment and potadine soaking dressing were performed to facilitate spontaneous closing of the lacrimal fistula. However, the lacrimal fistula relapsed and lacrimal fistulectomy and bicanalicular silicone tube intubation were performed. During surgery, silicone tube remnant material not totally extubated at the lacrimal sac was found which we removed. Postoperatively, systemic antibiotic therapy was administered and the chronic inflammation improved. CONCLUSIONS: We report a case of lacrimal fistula caused by silicone tube remnant in the lacrimal sac. Acquired lacrimal fistula caused by a silicone tube remnant can be treated by fistulectomy and silicone tube remnant removal.

Clinical Study of Lacrimal Fistulas in the Oculoplastic Surgery

Lacrimal fistula, a rare developmental disorder, may result from an abnormal budding of the epithelial cord of the lacrimal system. Most cases are unilateral, however, bilateral cases are still more rare, which are combined with other systemic diseases or accompanying disorders. This entity has so far been known only to ophthalmologist. We would like to illustrate lacrimal fistula in patients who were referred to our clinic for periorbital cosmetic surgery, such as blepharoptosis and epicanthus, from April 2005 to December 2007. Fistular orifices of all 6 patients were had been located inferomedial to medial canthi along the epicanthal fold. Out of 6 patients, 4 patients presented with unilateral lacrimal fistula; right side in 3 patients and left side in 1 patient, and bilateral lacrimal fistulas in 2 patients. Three cases were found to have positive connection between the nasolacrimal apparatus, and blind pouch type in 5 cases. Three out of six patients underwent fistulectomy with concurrent cosmetic periorbital surgery. In 2 patients who presented with connection with the nasolacrimal apparatus, fistulectomy and lacrimal sac or the common lacrimal canaliculi repair was performed as well. The remaining one patient with bilateral blind pouch type of lacrimal fistulas underwent a simple fistulectomy. There were no postoperative complications or any recurrences.

Treatment of the Lacrimal Fistula with Punctal Plug

PURPOSE: To evaluate the results and complications of the punctal plug insertion through lacrimal fistula. METHODS: Four patients diagnosed with congenital lacrimal fistula had a punctual plug inserted through the lacrimal fistula without anesthesia from January to May 2005. RESULTS: Mean follow-up period was 6.8 months. In two pediatric patients whose mean age was 5.0 years, the fistula was not associated with nasolacrimal duct. In two adult patients, it was associated nasolacrimal duct obstruction, whose mean age was 49.0 years. In all cases epiphora improved. There was a puncal plug prolapse in one case and no other complications. CONCLUSIONS: Punctal plug insertion is considered a simple and useful technique for lacrimal fistula without congenital nasolacrimal obstruction in children especially whose parents refuse general anesthesia. Punctal plug insertion can be useful to reduce scarring in adult patients that receive endoscopic dacryocystorhinostomy with nasolacrimal obstruction.

The Clinical Manifestations and Treatment Results of Congenital Lacrimal Fistula

PURPOSE: To evaluate the clinical manifestations and the results of treatment in congenital lacrimal fistula. METHODS: We retrospectively evaluated the symptoms, associated anomalies, and results of treatment in patients with congenital lacrimal fistula. RESULTS: The mean age of the 22 total patients was 22.5+/-24.6 years (4 months~77 years). Associated anomalies were shown in two patients - one with hearing loss and upper punctal atresia, and the other with imperforate anus and undescended testes. Symptoms were tearing in 18 eyes and subcutaneous nodule in 3 eyes. Most of the external ostium of the fistula were located at the skin inferomedial (16 eyes) or medial (5 eyes) to the medial canthus, but one case had external ostium at the medial palpebral conjunctiva. Symptom improved in all patients after fistulectomy with bicanalicular intubation in 12 eyes, fistulectomy in 1 eye, bicanalicular intubation in 1 eye, and dacryocystorhinostomy combined fistulectomy with bicanalicular intubation in 2 eyes. However, the fistula recurred in 3 cases (19%). CONCLUSIONS: Lacrimal fistula is a congenital anomaly which can cause tearing or subcutaneous nodule. Treatment appropriate to the patient is required to get favorable result.

The Clinical Evaluation of Congenital Lacrimal Fistula

PURPOSE: To evaluate the surgical results and clinical characteristics of congenital lacrimal fistula. METHODS: Fourteen patients were diagnosed with congenital lacrimal fistula and received simple fistulectomy. Three patients received anterior lamella reposition operation simultaneously due to epiblepharon. We retrospectively reviewed the medical records and conducted telephone interviews. RESULTS: In 15 eyes of the 14 patients, epiphora through lacrimal fistula disappeared. Two eyes of 2 patients showed a little epiphora only outdoors but there was no need of further treatment. All patients accepted the surgical results cosmetically. Histologically, stratified squamous epithelial change with keratinization was remarkable by aging. In adults, hair follicles with increased keratinization were contained and the result with skin was similar. CONCLUSIONS: Simple fistulectomy was a useful technique for congenital lacrimal fistula.

Surgery for the Congenital Lacrimal Fistula

PURPOSE: Congenital lacrimal fistula, a rare developmental disorder, was reviewed to evaluate clinical features and surgical techniques with its results. METHODS: The clinical features of 9 patients who received operation are retrospectively reviewed, including presenting symptoms, surgical techniques and their results. RESULTS: Excision of the fistula alone was performed for cosmetic blemish and excision of fistula with bicanalicular silicone tube intubation was done for symptomatic tearing. None of the 9 patients had symptomatic or cosmetic problem postoperatively. CONCLUSIONS: Fistulectomy with or without bicanalicular silicone tube intubation is a successful procedure for congenital lacrimal fistula.