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Case Reports
. 2006 Mar;20(1):65-9.
doi: 10.3341/kjo.2006.20.1.65.

A silastic sheet found during endoscopic transnasal dacryocystorhinostomy for acute dacryocystitis

Jin Seok Choi  1 , Jong Hyeok Lee, Hae Jung Paik
Affiliations
Case Reports

A silastic sheet found during endoscopic transnasal dacryocystorhinostomy for acute dacryocystitis

Jin Seok Choi et al. Korean J Ophthalmol. 2006 Mar.

Abstract

Purpose: To report the case of a silastic sheet that was found during an endoscopic transnasal dacryocystorhinostomy for treatment of acute dacryocystitis with necrosis of the lacrimal sac.

Methods: A thirty-two year old male presented with painful swelling on the nasal side of his left lower lid two weeks prior to visiting this clinic. Fourteen years ago, the patient was involved in a traffic accident and underwent surgery to reconstruct the ethmoidal sinus. Lacrimal sac massage showed a regurgitation of a purulent discharge from the left lower punctum. Therefore, the patient was diagnosed with acute dacryocystitis and an endoscopic transnasal dacryocystostomy was performed the next day.

Results: The surgical finding showed severe necrosis around the lacrimal sac and a 20 x 15-mm sized silastic sheet was found crumpled within the purulent discharge. The sheet was removed, the lacrimal sac was irrigated with an antibiotic solution, and a silicone tube was intubated into the lacrimal pathway. After surgery, the painful swelling on the nasal side of left lower lid resolved gradually, and there were no symptomatic complications three months later.

Conclusions: We report the first case where a silastic sheet applied during a facial reconstruction had migrated adjacent to the lacrimal sac resulting in severe inflammation.

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Figures

Fig. 1
Fig. 1
First visits. (A & B) External photograph showing remarkable redness and swelling of the left medial epicanthal area.
Fig. 2
Fig. 2
Silastic sheet. (A) Intraoperative endoscopic photograph showing the tip of the silastic sheet adjacent to the lacrimal sac. (B) Intraoperative endoscopic photograph showing the removal of the silastic sheet with Blakesley forceps. (C) Photograph showing the silastic sheet, 20×15 mm in size, found during the endoscopic transnasal DCR.
Fig. 3
Fig. 3
Three months after surgery. (A & B) External photograph showing reduced redness and swelling of the left medial epicanthal area.
See this image and copyright information in PMC

References

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