Naso-orbito-ethmoidal fracture main cause of traumatic NLDO

Naso-orbito-ethmoidal fracture has been discovered as the main cause of traumatic nasolacrimal duct obstruction (NLDO), according to a paper in the European Journal of Ophthalmology.

Dr Bipasha Mukherjee et al., Department of Orbit, Oculoplasty, Reconstructive, and Aesthetic Surgery, Medical Research Foundation, Sankara Nethralaya, Chennai, India, reviewed 28 patients in the study. They retrospectively analysed data of the nature and pattern of injury, associated damage, clinical features, investigations, management, outcome and follow-up.

The most common cause of traumatic NLDO was high-velocity blunt injury encountered in road traffic accidents in 70% of patients, with the most common pattern of injury being naso-orbital-ethmoidal fractures in 64% of patients. Traumatic telecanthus was most commonly linked to periocular injury.

Of the the patients investigated, 75% were analysed with computed tomography-dacryocystography. External dacryocystorhinostomy was used to treat26 patients with or without silicon intubation and 2 patients underwent dacryocystorhinostomy. General and local anaesthesia was given to 68% and 32% of patients, respectively.

There was a successful outcome recorded in 96% of eyes operated with external dacryocystorhinostomy with or without silicone intubation. Telecanthus is an important presenting feature in the patients, with naso-orbito-ethmoidal fracture as the main cause of traumatic NLDO.

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