PMC2801633_01
A) Preoperative view of the patient showing a dacryocele (black arrows) and a saddle-nose deformity (white arrows), consequences of a Wegener's granulomatosis. B) Nasal endoscopy of the left nasal cavity. Extensive adhesions developed between the nasal septum and the inferior turbinate reducing dramatically the diameter of the nasal cavity. C) Preoperative sinus CT scan showing bilateral extensive adhesions in the nose (white arrows). D) Preoperative dacryoscan showing an opacification of all the lacrimal outflow system (white arrows).. Abbreviations: Adh, adhesions; CT, computed tomography; IT, inferior turbinate; S, nasal septum.
opth-3-651f1.jpg
PMC2801633_01_opth-3-651f1.jpg
f1-opth-3-651
Figure 1A shows the preoperative view of the patient with a saddle-nose deformity and a dacryocystocele. Figures 1C and 1D show two coronal views of a dacryoscan. Figures 1A and 1B show the changes of the nasal anatomy due to the vasculitis. The synechiae reduced the nasal airflow (as shown in Figure 1B) and caused bilateral obstruction of the nasolacrimal duct.
A) Postoperative view of the patient confirming the disappearance of the dacryocele (black arrows). B) Postoperative endoscopy of the left nasal cavity showing the absence of recurrence of the adhesions posteriorly. C and D) Postoperative dacryoscan confirming the patency of the surgical opening on the left side: presence of medium contrast in the nasal cavity (white arrow).
opth-3-651f2.jpg
PMC2801633_01_opth-3-651f2.jpg
f2-opth-3-651
Figure 2 illustrates the postoperative result. The dacryocele disappeared and the patient did not experience any new episode of infection (Figure 2A). A postoperative dacryoscan confirmed the patency of the surgical opening (Figures 2C and 2D). The adhesions recurred slightly but the nasal patency was still better than the one observed preoperatively (Figure 2B).