Lacrimal drainage surgery in Wegener's granulomatosis

Abstract

Aim: To examine the results of open lacrimal surgery in patients with Wegener's granulomatosis.

Methods: A retrospective review of patients with Wegener's granulomatosis who underwent lacrimal surgery over a 17 year period.

Results: 11 patients were identified and a total of 14 primary dacryocystorhinostomies (DCR) and one revisional DCR were performed; symptomatic relief was achieved in 13/14 operations and one patient required revisional surgery for persistent symptoms. There were no intraoperative and few postoperative complications.

Conclusions: In contrast with some previous reports, open DCR appears to be a safe procedure and it is recommended as a treatment for lacrimal obstruction in patients with Wegener's granulomatosis, but an increase of perioperative immunosuppression is recommended in certain cases.

Figure 1

Patient with extensive loss of nasal structure due to long standing Wegener's granuloma (case 4). The collapse of her nasal bridge is associated with loss of the upper portion of the anterior nasal air space, that which normally lies alongside the lacrimal sac fossa.