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A silastic sheet found during endoscopic transnasal dacryocystorhinostomy for acute dacryocystitis.

Choi JS, Lee JH, Paik HJ - Korean J Ophthalmol (2006)

Bottom Line: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge.After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later.We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gachon Medical School, Gil Medical Center, Inchon, Korea.

ABSTRACT

Purpose: To report the case of a silastic sheet that was found during an endoscopic transnasal dacryocystorhinostomy for treatment of acute dacryocystitis with necrosis of the lacrimal sac.

Methods: A thirty-two year old male presented with painful swelling on the nasal side of his left lower lid two weeks prior to visiting this clinic. Fourteen years ago, the patient was involved in a traffic accident and underwent surgery to reconstruct the ethmoidal sinus. Lacrimal sac massage showed a regurgitation of a purulent discharge from the left lower punctum. Therefore, the patient was diagnosed with acute dacryocystitis and an endoscopic transnasal dacryocystostomy was performed the next day.

Results: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge. The sheet was removed, the lacrimal sac was irrigated with an antibiotic solution, and a silicone tube was intubated into the lacrimal pathway. After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later.

Conclusions: We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.

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Related in: MedlinePlus

Three months after surgery. (A & B) External photograph showing reduced redness and swelling of the left medial epicanthal area.
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Figure 3: Three months after surgery. (A & B) External photograph showing reduced redness and swelling of the left medial epicanthal area.

Mentions: One day after surgery, the silicone tube was positioned at the medial canthus. The painful swelling around the medial canthal area of the left lower lid was slightly decreased, and no pus-like discharge was found upon lacrimal sac massage. The patient was discharged with a prescription of topical antibiotics, steroid, oral antibiotics, and non-steroidal anti-inflammatory agent, and was followed up at the outpatient department. The painful swelling on the nasal side of his left lower lid resolved gradually, and there were no symptomatic complications after removing the silicone tube three months later (Fig. 3).


A silastic sheet found during endoscopic transnasal dacryocystorhinostomy for acute dacryocystitis.

Choi JS, Lee JH, Paik HJ - Korean J Ophthalmol (2006)

Three months after surgery. (A & B) External photograph showing reduced redness and swelling of the left medial epicanthal area.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC2908819&req=5

Figure 3: Three months after surgery. (A & B) External photograph showing reduced redness and swelling of the left medial epicanthal area.
Mentions: One day after surgery, the silicone tube was positioned at the medial canthus. The painful swelling around the medial canthal area of the left lower lid was slightly decreased, and no pus-like discharge was found upon lacrimal sac massage. The patient was discharged with a prescription of topical antibiotics, steroid, oral antibiotics, and non-steroidal anti-inflammatory agent, and was followed up at the outpatient department. The painful swelling on the nasal side of his left lower lid resolved gradually, and there were no symptomatic complications after removing the silicone tube three months later (Fig. 3).

Bottom Line: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge.After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later.We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.

View Article: PubMed Central - PubMed

Affiliation: Department of Ophthalmology, Gachon Medical School, Gil Medical Center, Inchon, Korea.

ABSTRACT

Purpose: To report the case of a silastic sheet that was found during an endoscopic transnasal dacryocystorhinostomy for treatment of acute dacryocystitis with necrosis of the lacrimal sac.

Methods: A thirty-two year old male presented with painful swelling on the nasal side of his left lower lid two weeks prior to visiting this clinic. Fourteen years ago, the patient was involved in a traffic accident and underwent surgery to reconstruct the ethmoidal sinus. Lacrimal sac massage showed a regurgitation of a purulent discharge from the left lower punctum. Therefore, the patient was diagnosed with acute dacryocystitis and an endoscopic transnasal dacryocystostomy was performed the next day.

Results: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge. The sheet was removed, the lacrimal sac was irrigated with an antibiotic solution, and a silicone tube was intubated into the lacrimal pathway. After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later.

Conclusions: We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.

Show MeSH
Related in: MedlinePlus