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Impressum
Non-Infectious Dacryolithiasis after fracture of the nasal bone
Hübsch S., Schmidt W.
Zentrum für Augenheilkunde, Friedrichstr.18, D-35392 Gießen
Introduction: Dacryoliths are rare and have to be differentiated
from other causes of stenosis of the lacrimal duct.
Material and Methods: After a spontaneous passage, a dacryolith
has been analysed by means of histology, raster electron mikroscope, high
frequency sonography and micro-CT. An element analysis was performed by
atomic absorption spectrometry (AAS).
Case report: A 40-year-old woman had recurrent symptoms of epiphora
and painful hardening in the region of the lacrimal sac. Each time those
symptoms disappeared shortly after passage of a dacryolith. Three years
ago, the nasel bone was fractured. Besides, stones of the gall bladder,
the kidney and the bladder are known, but never have been analysed. The
dacryocystography showed before and shortly after the passage of the dacryolith
a stenosis of the ductus nasolacrimalis, that was followed by a further
passage. High frequency ultrasound demonstrated an irregular structure
of the surface with a central pathway. In the radiographic examination
(22 KV) in vitro, no X-ray density could be detected. An element analysis
indicated organic material which could be proved by means of raster electron
microscope (C 71,5%, N 8,8%, O 18,77%, Na 0,12%, S 0,39%, K 0,29%). Furthermore
the dacryolith was analysed by AAS. Endonasal surgery is planned to avoid
the development of further dacryoliths.