1887

Dental-related epiphora and dacryocystitis

image of Dental-related epiphora and dacryocystitis
GBP
Online Access: GBP25.00 + VAT
BSAVA Library Pass Buy a pass

Abstract

Knowledge of the normal anatomy of the nasolacrimal duct, and the structures through which it travels, is required to investigate and treat rabbits with epiphora, dacryocystitis and chronic nasal discharge. This chapter observes anatomy of the nasolacrimal duct and related structures; aetiopathogenesis; diagnosis; medical treatment; dental treatment; surgical treatment; and prognosis. : Flushing the nasolacrimal duct; Marsupialization of the lacrimal sac.

Loading full text...

Full text loading...

/content/chapter/10.22233/9781910443163.chap28

Figures

Image of 28.1
28.1 The single ventral lacrimal punctum, with an intravenous catheter entering it.
Image of 28.2
28.2 The bony lacrimal canal, through which the nasolacrimal duct is visible on this plain lateral radiograph (white arrow).
Image of 28.3
28.3 The facial dermatitis shown by this rabbit is due to tear overflow on to the fur and skin. (Courtesy of Frances Harcourt-Brown)
Image of 28.4
28.4 Mutual grooming is a part of the rabbit’s social behaviour. (Courtesy of ME Buseth)
Image of 28.5
28.5 Severe keratoconjunctivitis, blepharitis and periorbital dermatitis secondary to dacryocystitis. (Courtesy of L Duckworth)
Image of 28.6
28.6 Positive-contrast lateral dacryocystograph showing the normal nasolacrimal duct.
Image of 28.7
28.7 Positive-contrast study of a rabbit with dacryocystitis affecting the right eye. On this lateral view, the nasolacrimal duct is filled with aqueous positive contrast medium (iohexol), showing that the nasal section of the duct has ruptured into the maxillary sinus (white arrow). There is pathology and apical elongation of the 1st incisor, which is distorting the maxillary bone and occluding the nasolacrimal duct. The tooth has no enamel or pulp cavity (yellow arrow). There is also deformity and apical elongation of the cheek teeth. Dorsoventral view of the same rabbit. Iohexol had also been instilled into the left nasolacrimal duct, which was not obstructed. A thin line of contrast material can be seen in the nasal section of the duct. (Courtesy of Frances Harcourt-Brown) (Image reproduced from , with permission)
Image of 28.8
28.8 This contrast CT series shows three views (from top to bottom: sagittal, coronal, transverse) of the left nasolacrimal duct. The orange arrows mark the duct, filled with water-based contrast material. (Courtesy of Laura Crews)
Image of 28.9
28.9 MRI scan (coronal plane) of a rabbit skull. There is severe rhinitis, sinusitis and associated bone lysis and dacryocystitis on the worst affected side (R).
Image of 28.10
28.10 Before treatment, there is significant purulent discharge from both ends of the nasolacrimal duct. After systemic antibiotic treatment, mild epiphora remains.
Image of 28.11
28.11 Erosion of the maxilla and spontaneous rupture of the nasolacrimal duct. Prepared maxilla of a rabbit with advanced dental disease. The elongated apex of the incisor has curved towards the nasal passages and penetrated the bone (arrow). The site of this lesion can be seen in , a dacryocystogram of a nasolacrimal duct blocked by an elongated curved incisor that has not penetrated the bone. Penetration of the bone and diversion on lacrimal fluid into the nasal cavity can be seen in , a dacryocystogram of an anaesthetized rabbit with severe dacrocystitis. The iohexol has bypassed the distal section of the nasolacrimal duct, and can be seen in the nasal cavity; this improved drainage assisted in resolution of the clinical signs. (Courtesy of Frances Harcourt-Brown; (b) reproduced from , with permission)
Image of Untitled
Image of The punctum is identified in the ventral eyelid.
The punctum is identified in the ventral eyelid. The punctum is identified in the ventral eyelid.
Image of A suitable cannula is inserted into the punctum.
A suitable cannula is inserted into the punctum. A suitable cannula is inserted into the punctum.
Image of Sterile fluid is passed through the cannula and nasolacrimal duct until it flows freely.
Sterile fluid is passed through the cannula and nasolacrimal duct until it flows freely. Sterile fluid is passed through the cannula and nasolacrimal duct until it flows freely.
Image of Applying digital pressure to the swelling will squeeze copious amounts of purulent secretion through the lacrimal punctum into the conjunctival sac.
Applying digital pressure to the swelling will squeeze copious amounts of purulent secretion through the lacrimal punctum into the conjunctival sac. Applying digital pressure to the swelling will squeeze copious amounts of purulent secretion through the lacrimal punctum into the conjunctival sac.
Image of Constant contact with pus can result in a painful keratoconjunctivitis.
Constant contact with pus can result in a painful keratoconjunctivitis. Constant contact with pus can result in a painful keratoconjunctivitis.
Image of Lateral skull radiograph of a rabbit with a profuse unilateral ocular and nasal discharge and a palpably dilated lacrimal sac. There is radiopacity of the maxillary sinus and a fractured maxillary incisor (arrow). The root was infected and obstructing the nasolacrimal duct.
Lateral skull radiograph of a rabbit with a profuse unilateral ocular and nasal discharge and a palpably dilated lacrimal sac. There is radiopacity of the maxillary sinus and a fractured maxillary incisor (arrow). The root was infected and obstructing the nasolacrimal duct. Lateral skull radiograph of a rabbit with a profuse unilateral ocular and nasal discharge and a palpably dilated lacrimal sac. There is radiopacity of the maxillary sinus and a fractured maxillary incisor (arrow). The root was infected and obstructing the nasolacrimal duct.
Image of Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Image of Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Image of Post-mortem dissection to show the position of the lacrimal sac.
Post-mortem dissection to show the position of the lacrimal sac. Post-mortem dissection to show the position of the lacrimal sac.
Image of Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission. Drawn by S.J. Elmhurst BA Hons (www.livingart.org.uk) and reproduced with her permission.
Image of Vertical view of lacrimal sac after removal of tented wall.
Vertical view of lacrimal sac after removal of tented wall. Vertical view of lacrimal sac after removal of tented wall.
Image of Lateral aspect of lacrimal sac to show resected section.
Lateral aspect of lacrimal sac to show resected section. Lateral aspect of lacrimal sac to show resected section.
Image of Untitled
Image of Postoperative appearance immediately after marsupialization.
Postoperative appearance immediately after marsupialization. Postoperative appearance immediately after marsupialization.
Image of Same rabbit as above, 5 days postoperatively.
Same rabbit as above, 5 days postoperatively. Same rabbit as above, 5 days postoperatively.
Image of Untitled
Image of In some cases where infection is still present in the lacrimal duct, a fistula may form beneath the medial canthus. A cannula can be inserted to flush material through the duct and out of the nose.
In some cases where infection is still present in the lacrimal duct, a fistula may form beneath the medial canthus. A cannula can be inserted to flush material through the duct and out of the nose. In some cases where infection is still present in the lacrimal duct, a fistula may form beneath the medial canthus. A cannula can be inserted to flush material through the duct and out of the nose.

More like this

/content/chapter/10.22233/9781910443163.chap28
dcterms_title,dcterms_description
5
5
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error