Massive enlargement of the nasolacrimal canal causing epiphora and chronic maxillary sinusitis.

Abstract

Enlargement of the nasolacrimal canal (NLC) is a rare anatomic variant. We present the first report of a massively dilated NLC causing epiphora and chronic sinusitis. The authors conducted a literature review and case report. A 65-year-old man with refractory sinonasal symptoms and a remote history of a dacryocystorhinostomy was found to have a massively dilated, air-filled NLC. Using a combined endoscopic transnasal and endoscope-assisted Caldwell-Luc approach, the posterolateral wall of the NLC was removed. The patient's symptoms were improved 10 months postoperatively. Symptoms suggestive of nasolacrimal dysfunction should prompt a search for potential sinonasal pathology.