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Epiphora and the Bony Naso-Lacrimal Canal

1956; BMJ; Volume: 40; Issue: 11 Linguagem: Inglês

10.1136/bjo.40.11.673

1468-2079

C. I. Phillips, Martin A. George,

Urological Disorders and Treatments

IT is possible to obtain a radiographic view of the naso-lacrimal canal "end-on" by directing a beam of x-rays down the axis of the canal to a film held horizontally in the mouth: the centre of the film is placed near the site of the first molar tooth (Brunetti, 1930;Kopylow, 1930; Toth, 1933), or the second pre-molar.Examples of such radiographs are shown in Figs 1, 2, and 3.The present investigation has been undertaken to com- pare the sizes of the bony canals thus observed in a series of normal subjects with those in a series of patients with epiphora.Material Surgeons of Moorfields, Westminster and Central Eye Hospital were requested to send patients complaining of epiphora to the Radiological Department where they were x-rayed (see below).The results of syringing the naso-lacrimal passages had usually been recorded on the case-sheets; in the few cases where this information was not available for the symptom- free side in unilateral cases, a test syringing was carried out.Patients who had abnormalities of the puncta or canaliculi, or a history of facial injury involving, or operations on, the tear-passages, were excluded.It is interest- ing to note that four out of twenty epiphoric eyes (see Table I) had passages which were patent on syringing: the cause of epiphora in these cases was not clear.No case was recorded as having obstruction of the common canaliculus along with obstruction of the naso-lacrimal duct.The control sample was selected from patients referred for x-ray of skull, sinuses, teeth, chest, etc., for various reasons such as headaches and iridocyclitis.The same sex ratio was chosen in the control as in the affected group and each control was selected so that his or her age was within 3 years of at least one of the affected, with three exceptions: epiphorics F 78 and M 52 were not paired, and F 65 was controlled by F 60.There is no significant difference between the mean age of controls and affected (t=0-33; n=27; P very much >0-10).The affected group is thus not a random sample of epi- phorics in Great Britain, and the control group is even less a random sample of individuals of the same age, sex, race, stature, etc., as the affected, but