RESUMO
Nasolacrimal duct obstruction is common sequel following naso-orbito ethmoidal fractures. After 2 months of receiving conservative treatment, a 24-year-old male patient reported epiphora from the right eye following self-fall from a tree. Lacrimal sac mucocele was diagnosed and mucopurulent regurgitation noted on finger pressure and lacrimal sac syringing. Computed tomography revealed healed old fractures involving right nasal bone, maxillary nasal process adjacent to the medial orbital wall with lytic areas. Possibility of the subperiosteal abscess with osteomyelitis changes was suspected. A thick fibro-osseous (sequestrum) wall formation was noted separating nasal cavity and orbit. Lateral nasal wall adhesions were released by transnasal endoscopy. Two weeks later, the thick wall was fenestrated through external dacryocystorhinostomy approach. Lacrimal sac mucocele opened and bicanalicular silicone intubation performed. Epiphora relieved and lacrimal passage patency maintained and confirmed by lacrimal sac syringing on 3 months follow-up. To evaluate etiopathogenesis and patency, integrity of silicone intubation is the purpose of presenting this case.