The Eurasian Journal of Medicine
Original Article

Sinonasal Anatomical Variations and Primary Acquired Nasolacrimal Duct Obstruction: A Single Centre, Case-Control Investigation


Department of Otolaryngology, Urmia University of Medical Sciences, Urmia, Iran


Department of Ophthalmology, Urmia University of Medical Sciences, Urmia, Iran

Eurasian J Med 2020; 52: 21-24
DOI: 10.5152/eurasianjmed.2019.19034
Read: 704 Downloads: 218 Published: 03 September 2019


Objective: Primary acquired nasolacrimal duct obstruction (PANDO) is an idiopathic narrowing of the nasolacrimal duct caused by chronic inflammation and consecutive stenosis of the tissue. In the current investigation we aimed to study the etiopathogenic role of sinonasal anatomical abnormalities and paranasal inflammatory pathologies in PANDO.
Material and Methods: CT findings of 459 patients who had been diagnosed with unilateral PANDO in the period between April 2009 and March 2017 were compared with that of a control group, comprising 200 subjects without nasolacrimal duct obstruction who had referred to the ear nose throat (ENT) clinic with the complaint of vertigo and headache. A radiologist masked to the clinical situation of participants, examined the CT findings retrospectively.
Results: The prevalence of deviated nasal septum was found to be strongly associated with PANDO incidence (55.3% on PANDO side of patients vs. 28.3% among controls; p ˂ 0.001). Significant increases, albeit of smaller magnitude, were also observed in the relative frequency of Agger nasi cells and maxillary sinusitis on PANDO side of cases (14.6% and 27.0%, respectively) compared to controls (9.5% and 20.6%, respectively) (p = 0.023 and p = 0.038, respectively). Unilateral PANDO was also found to be robustly associated with ipsilateral deviated nasal septum (p ˂ 0.001). The odds of septal deviation occurrence were 3.037 times (95% Confidence Interval (CI), 2.303-3.990; p ˂ 0.001) more on the PANDO than non-PANDO side of the studied cases.
Discussion: Ipsilaterally deviated nasal septum appears to have a role in the development of unilateral primary acquired obstructive disease of the lacrimal drainage system. The incidence of PANDO might also be affected with Agger nasi cells and maxillary sinusitis. Multicenter studies are essential to further elucidate the interaction between type, severity, extent, and dimensions of different pathologies with nasolacrimal duct obstruction.
Cite this article as: Samarei R, Samarei V, Samadi Aidenloo N, Fateh N. Sinonasal Anatomical Variations and Primary Acquired Nasolacrimal Duct Obstruction: A Single Centre, Case-Control Investigation. Eurasian J Med 2020; 52(1): 21-4.
EISSN 1308-8742