Presurgical and postsurgical ultrasound assessment of lacrimal drainage dysfunction.

Abstract

In addition to the obligatory clinical tests, imaging of the lacrimal drainage system (LDS) is useful in its clinical evaluation. The purpose of this study was to examine the usability and reliability of ultrasonography in the evaluation of the lacrimal drainage system. Observational cohort study. A prospective study was conducted at a single institution. We performed ultrasound examinations on 17 patients with epiphora before and after surgery, and on 17 asymptomatic volunteers, to visualize and evaluate the anatomic and functional condition or pathologic abnormalities of the LDS. Echographic evaluation of the LDS was possible in all individuals. Pathologic abnormalities (canaliculitis, diverticulitis, concretion, or dilation of the lacrimal sac, and reduced functionality of the orbicular muscle and/or lacrimal sac pump) could be well demonstrated. In the postsurgical course, functional patency of the dacryocystorhinostomy opening could be verified in all cases. Sonography of the LDS appears to represent a reliable diagnostic technique supplementary to clinical tests in the presurgical and postsurgical examination of patients with epiphora. Pathologic abnormalities that may not be apparent in routine x-ray dacryocystography can be demonstrated with ultrasound techniques. Patients also benefit from the avoidance of exposure to ionizing radiation. However, ultrasound is not suitable for imaging the lower part of the lacrimal sac and the lacrimal duct because of the presence of overlying bony structures.