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ARTICLE
Year : 1965  |  Volume : 13  |  Issue : 2  |  Page : 55-58

X-ray study of the nasolacrimal canal inlet


Dept. of Ophthalmology, G. R. Medical College, Gwalior, India

Date of Web Publication21-Feb-2008

Correspondence Address:
B Shukla
Dept. of Ophthalmology, G. R. Medical College, Gwalior
India
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Source of Support: None, Conflict of Interest: None


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How to cite this article:
Shukla B, Firdosi A H. X-ray study of the nasolacrimal canal inlet. Indian J Ophthalmol 1965;13:55-8

How to cite this URL:
Shukla B, Firdosi A H. X-ray study of the nasolacrimal canal inlet. Indian J Ophthalmol [serial online] 1965 [cited 2020 Sep 23];13:55-8. Available from: http://www.ijo.in/text.asp?1965/13/2/55/39214

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Table 2

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Table 1

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Table 1

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Dacryocystitis was first believed to be a disease of the orbital bones.-- Duke-Elder (1952). Ferandez (1921) thought that narrowness of the naso­lacrimal canal is responsible for the higher incidence of dacryocystitis in the white races as compared to the negroes. Similarly Metier (1929) main­tained that higher incidence of the disease in the females is due to nar­rower nasolacrimal canal. Zabel (1900) and Onodi (1913) observed that a spur on the anterior or the posterior lacri­mal crest or a well developed hamular process may constrict the lacrimal sac.

Radiography of the naso-lacrimal canal was first studied by Brunetti (1930) Kopylow (1930) and Toth (1932). Phillips and George (1956) studied the size of the inlet in 10 nor­mal and 17 epiphoric eyes and found no significant difference. Kesavachar (1952) conducted a similar study on 21 normal and 24 epiphoric eyes. He concluded that the epiphoric eyes have a narrower inlet of the naso-lacrimal canal leading to obstruction.


  Material and Method Top


A random survey of cases of chronic dacryocystitis was done. Fifty cases were selected in all between the ages of 4 and 80 years. Of these 21 were males and 29 were females. Ten nor­mal cases were studied as control. The technique employed was the same as described by Toth (1932) and followed by Phillips and George (1956).

The patient was seated comfortably in a chair and his head was slightly lilted backwards so that the base line between the outer canthus and the external auditory meatus was at an angle of 30° with the horizontal level. In this way the frontal bone does not ob­struct the view of the canal. A dental film of 1½ x 2 inches was placed in- side the mouth just beneath the upper second premolar tooth. A small conical X-ray machine was placed above the patient pointing towards the inlet of the naso-lacrimal canal. A current of 10 M.A. was set and an exposure of 3 seconds was given. Similar procedure was repeated for the other side. The film was immediately developed, washed and seen and if the results were unsatisfactory it was repeated.


  Observations Top


An elliptical contour corresponding to the inlet of the nasolacrimal canal inlet can be seen in the exposed film. The area was measured in square milli- meters from the length and breadth of the opening with the help of a trans- parent graph paper, counting the number of squares covered. The observations were recorded in tabular form of normal, unilateral and bilateral cases. See [Table - 1],[Table - 2],[Table - 3],[Table - 4].

The results cannot be comparable between cases, but since the study comprises mostly a comparison bet­ween the right and left inlets of the same patient, the comparisons are sig­nificant.


  Discussion Top


The area of the naso-lacrimal canal inlet, its length, width and course may all contribute to the obstruction of the lacrimal passages. It can be seen [Table - 1] that the area of the naso­lacrimal canal inlet is slightly smaller in the females (4.4 mm.). However in view of the fact that there is an aver­age variation between the right and the left inlets in normal cases of 5.6 mm. this difference is of no statistical signi­ficance. Again there is little evidence to suggest that the area of the inlet by itself has a significant role [Table - 4].

There is hardly any difference in the average area of the inlet in the normal (23.6 sq mm.) and bilateral cases of chronic dacryocystitis (22.7 sq. mm.). Similarly in the unilateral cases the average difference between the normal and the affected eye was only 3.8 sq. mm., whereas in the normal cases it is 5.6 sq. mm. [Table - 4]. These figures indicate that the area of the inlet of the nasolacrimal canal is not a contributory factor in the patho­genesis of chronic dacryocystitis.

This is in accordance with the ob­servations of Phillips and George (1956), although the observations of Kesavachar are different. However both of them had studied cases of epi­phora which were not necessarily cases of chronic dacryocystitis as in the pre­sent study.[10]


  Conclusion Top


The inlet of the nasolacrimal canal was studied by X-rays in ten normal cases and fifty of chronic dacryocysti­tis. The area of the inlet was measur­ed and compared in sq. mm. and it was concluded that it has no signifi­cant bearing in the causation of the disease. However the shape of the canal seems to be an important fac­tor, as a bony spur or septa may very likely cause stenosis as was seen in one case at least.

We are grateful to Dr. K. C. Maju­puria and Dr. J. S. Saxena of the Radiology department for their kind help in conducting this study.

 
  References Top

1.
Brunetti (1930) Atti Cong. Hal. Radiol. Med., 2, 25.  Back to cited text no. 1
    
2.
Duke-Elder (1952) Text Book of Oph.. Vol. 5, p. 5,300. Henry Kimpton. London.  Back to cited text no. 2
    
3.
Fernandez (1921) Am. J. Ophth. 4, 32.  Back to cited text no. 3
    
4.
Kesavachar K. R. (1958) J. All. Ind. Oph. Soc., 6, 61.  Back to cited text no. 4
    
5.
Kopylow (1930) Roentgenpraxis, 2, 686.  Back to cited text no. 5
    
6.
Meller (1929) Trans. Ophth. Soc. U.K., 49, 233.  Back to cited text no. 6
    
7.
Onodi (1913) Cited by Duke-Elder in Vol. 11. p. 5,303.  Back to cited text no. 7
    
8.
Phillips C. and George M. (1956) Brit. J. Oph., 40, 673.  Back to cited text no. 8
    
9.
Toth (1932) Klin. Monats. Aug., 89, 555.  Back to cited text no. 9
    
10.
Zabel (1900) Anat. Hefte, 15, 153.  Back to cited text no. 10
    


    Figures

  [Figure - 1], [Figure - 2], [Figure - 3]
 
 
    Tables

  [Table - 1], [Table - 2], [Table - 3], [Table - 4]



 

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Material and Method
Observations
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