Dacryoliths in a series of dacryocystorhinostomies: histologic and chemical analysis

Abstract

Purpose: To present the clinical and intraoperative characteristics of dacryolith cases, to present their histologic and chemical analysis, and to relate the findings with the probable causes of their formation in a series of dacryocystorhinostomies performed in northern Greece.

Methods: In a series of 242 dacryocystorhinostomies in patients with chronic dacryocystitis, dacryoliths large enough to perform an accurate chemical analysis and a light histologic examination were found in five cases. The chemical analysis was based on atomic absorption spectrophotometry and atomic emission spectrometry.

Results: These five cases concerned relatively young patients who presented symptoms of short duration as compared to the other dacryocystorhinostomy cases. In three of them, irregularities of the lacrimal sac wall were observed. The final postoperative results were satisfactory. The histologic examination revealed acellular amorphous organic material and limited areas with characteristics of calcium salt depositions. The chemical analysis showed mainly organic and minimal inorganic material.

Conclusions: The irregularities of the lacrimal sac wall and the consequent flow disorders within the sac and the histologic and chemical analysis of the dacryoliths provide evidence for etiologic consideration.