An Unusual Case of Nasolacrimal Obstruction Caused by Foodstuffs.
Bottom Line: Here we report a case of nasolacrimal obstruction resulting from rice grains ingested over many years that had formed an obstructive mass.In Japan, we call this 'learning new lessons from the past'.This implies that newer techniques may not necessarily be superior and traditional techniques can offer advantages of safety and simplicity in treating this condition.
Affiliation: Matsumoto Medical Clinic, Ashiya, Japan.
Here we report a case of nasolacrimal obstruction resulting from rice grains ingested over many years that had formed an obstructive mass. This is a hitherto unreported cause of nasolacrimal obstruction. We exclusively treated the obstruction safely with repeated irrigation with physiological saline. Although there have been various reports on new techniques such as the blind insertion of a bougie and insertion of a silicon tube under endoscopic guidance, successful treatment of this condition is possible with an old-fashioned approach using the time-honored tools of a syringe and an irrigation needle, if utilized patiently and repeatedly. In Japan, we call this 'learning new lessons from the past'. This implies that newer techniques may not necessarily be superior and traditional techniques can offer advantages of safety and simplicity in treating this condition.
No MeSH data available.
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Mentions: The patient, a 39-year-old male who works as a surgeon and is the lead author of this report, experienced abnormal lacrimation of the left eye while at work. He underwent irrigation performed by the second author, who is an ophthalmologist. However, the condition recurred 5 times during the following 2 years despite repeated irrigation on each occasion. During the sixth treatment, after approximately 20 irrigations had been completed, an object was suddenly ejected into the rear of the patient's nasal cavity. On histological examination, this object was found to be an agglomeration of rice grains (fig. 1, fig. 2) and was believed to have penetrated the nasolacrimal duct over a long period via reflux through Hasner's valve. This mass then became molded into a rectangular, cone-shaped plug, matching the shape of the nasolacrimal duct. Since this successful treatment, there has been no further recurrence. Approximately 1 month after completing treatment, the author underwent detailed examination of the paranasal sinuses by an otolaryngologist using fiberscopy. Although it was not possible to view up to Hasner's valve, no other abnormalities were noted within the range visible by fiberscopy.
No MeSH data available.