We report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus. A systemically healthy 1-year-old girl came to the outpatient clinic with a complaint of tearing on the temporal side of the right lateral canthus since birth. On examination, a small orifice was found in the skin on the temporal side of the lateral canthus. There was no evidence of inflammation or swelling within the opening. Surgeons carried out an operation under general anesthesia. They passed a probe through the lacrimal orifice and advanced it toward the lacrimal sac. Next, they introduced saline to the inferior punctum and found that it drained to the lateral fistula. The lower lid stretched as the dissected fistula was pulled. After the operation, the patient was free of the symptom. This paper is to report a case of congenital lacrimal sac fistula located on the temporal side of the lateral canthus.
Diagnosis, Differential ; *Eye Abnormalities ; Female ; Fistula/*congenital/diagnosis ; Humans ; Infant ; Lacrimal Apparatus/*abnormalities ; Lacrimal Apparatus Diseases/*congenital/diagnosis

Telecanthus is a common symptom accompanied by Waardenburg syndrome, a rare genetic disorder. The optimal surgery for telecanthus correction is still debated. A 28-year-old patient with Waardenburg syndrome underwent transnasal wiring canthopexy using a Y-V epicanthoplasty for telecanthus correction. A Mini-Monoka stent was used to prevent damage to the lacrimal apparatus. The intercanthal distance decreased from 50 mm to 43.2 mm. The easily designed Y-V epicanthoplasty incision provides sufficient operative field for oblique transnasal wiring, which is effective in properly positioning the medial canthal tendon. It has minimal scarring resulting in satisfactory cosmetic outcomes.
Adult ; Cicatrix ; Congenital Abnormalities ; Craniofacial Abnormalities ; Humans ; Lacrimal Apparatus ; Stents ; Tendons ; Waardenburg Syndrome

The purpose of this study is to discuss several approaches to addressing naso-orbito-ethmoidal (NOE) fracture. Orbital fracture, especially infraorbital fracture, can be treated through the transconjunctival approach easily. However, in more severe cases, for example, fracture extending to the medial orbital wall or zygomatico-frontal suture line, only transconjunctival incision is insufficient to secure good surgical field. And, it also has risk of tearing the conjunctiva, which could injure the lacrimal duct. Also, in most complex types of facial fracture such as NOE fracture or panfacial fracture, destruction of the structure often occurs, for example, trap-door deformity; a fracture of orbital floor where the inferiorly displaced blowout facture recoils to its original position, or vertical folding deformity; fractured fragments are displaced under the other fragments, causing multiple-packed layers of bone.
Congenital Abnormalities ; Conjunctiva ; Fractures, Multiple ; Lacrimal Apparatus ; Maxillary Fractures ; Orbit ; Orbital Fractures ; Sutures ; Tears

Congenital Abnormalities ; Depression ; Facial Nerve ; Hardness ; Hematoma ; Lacrimal Apparatus Diseases ; Paralysis ; Polyethylene ; Porosity ; Skull ; Surgery, Plastic ; Trismus

OBJECTIVETo explore the effective techniques for correction of lacrimal groove and palpebromalar groove deformity in the middle-aged and old people.

METHODThe lacrimal groove and palpebromalar groove deformity was corrected by the techniques of transcutaneous orbital fat releasing and pedicle orbital fat flap filling. From 1996 to 2011, 426 patients, aged from 35 to 72 (average, 48), were treated by the techniques. Among them, 54 patients had underwent the surgical treatment before this operation. 362 patients were followed up for 3-24 months.

RESULTSCompletely correction was achieved in 283 patients, obvious improvement in 79 patients. The result was not satisfied in 2 patients with severe deformity who had surgical treatment before.

CONCLUSIONThe lacrimal groove and palpebromalar groove deformity can be effectively corrected by transcutaneous orbital fat releasing and pedicle orbital fat flap in the middle-aged and old people.

Adipose Tissue ; transplantation ; Adult ; Aged ; Blepharoplasty ; methods ; Cheek ; abnormalities ; surgery ; Female ; Humans ; Lacrimal Apparatus ; abnormalities ; surgery ; Male ; Middle Aged ; Surgical Flaps

PURPOSE: To present a rare case of tear drainage since birth from a lacrimal ductule fistula, which is the first report in the Republic of Korea. CASE SUMMARY: 3-month-old female who presented with discharge of clear fluid from a small skin opening lateral to the right upper eyelid since birth visited the outpatient clinic. The patient was healthy and was receiving no medication. She was born on gestation age 35 weeks and 3 days. No other specific history or other ophthalmic abnormality was found. On examination, a small skin orifice approximately 2 mm diameter and no sign of infection or discoloration was observed. To relieve this symptom, the patient underwent a fistulectomy under general anesthesia. Histopathological examination of the surgical specimen was performed. The patient's symptom subsided postoperatively without recurrence. CONCLUSIONS: This is the first report in the Republic of Korea of tears draining from a lacrimal ductule fistula since birth and the subsequent clinical treatment procedures.
Ambulatory Care Facilities ; Anesthesia, General ; Congenital Abnormalities ; Drainage ; Eyelids ; Female ; Fistula ; Humans ; Infant ; Lacrimal Apparatus ; Parturition ; Pregnancy ; Recurrence ; Republic of Korea ; Skin ; Tears

PURPOSE: Squamous cell carcinoma of the lacrimal sac is rare and there is high rate of recurrence after dacryocystectomy. We report successful radical excision of the tumor for the purpose of reducing the recurrence and improving the survival rate. METHODS: A 48-year-old man who had a history of epiphora and medial canthal mass for one year was referred to our clinic. CT scan showed a mass on the lacrimal fossa but there was no evidence of bony destruction or local invasion. We confirmed that the excised mass was squamous cell carcinoma of the lacrimal sac by frozen section. So, radical excision including bony and mucous nasolacrimal duct (NLD), inferior turbinate, and medial maxilla was performed through lateral rhinotomy. RESULTS: Ten months later, there was skin defect and medial canthal deformity. So we corrected the deformity with a forehead free flap and the result was cosmetically acceptable. There was no evidence of recurrence or distant metastasis for one- year follow- up period. CONCLUSIONS: Despite its high recurrence rate, we can reduce the recurrence and mortality rate of squamous cell carcinoma of the lacrimal sac with radical excision including bony and mucous NLD, inferior turbinate, and medial maxilla.
Carcinoma, Squamous Cell* ; Congenital Abnormalities ; Forehead ; Free Tissue Flaps ; Frozen Sections ; Humans ; Lacrimal Apparatus Diseases ; Maxilla ; Middle Aged ; Mortality ; Nasolacrimal Duct ; Neoplasm Metastasis ; Recurrence ; Skin ; Survival Rate ; Tomography, X-Ray Computed ; Turbinates