Computed tomographic-dacryocystography (CT-DCG) of the normal canine nasolacrimal drainage system with three-dimensional reconstruction

The aims of the study were (1) to quantify the influence of selected imaging parameters on the image quality (slice thickness, mAs, and beam orientation) defining optimal conditions for scan protocols and (2) to evaluate the benefits of the 3D reconstruction techniques for visualization of NDS structures in dogs. CT-DCG was performed bilaterally in 32 heads of dogs. CT transverse images were obtained using a combination of two slice thickness values (0.8 mm and 2 mm) and two mAs values (50 mAs and 300 mAs). Two beam projection orientations were also tested: transverse plane (perpendicular to the hard palate) and oblique to the hard palate. Three-dimensional images were obtained using Volume Rendering (VR). Transverse beam projection proved to be superior for the assessment of the inferior and superior lacrimal canaliculi and lacrimal sac. In this study, there was no statistical difference regarding mAs values (50 mAs and 300 mAs) and slice thickness values (0.8 mm and 2 mm). Three-dimensional images were helpful for the assessment of topographic relationship between nasolacrimal structures and cranial landmarks.     

Nasolacrimal obstruction caused by root abscess of the upper canine in a cat

A 10‐year‐old, castrated male domestic short hair cat was presented to the Small Animal Clinic at the Western College of Veterinary Medicine with a presenting complaint of chronic, ocular discharge from the left eye. Ocular examination confirmed epiphora and mucopurulent discharge but there were no apparent reasons for the ocular discharge, and nasolacrimal obstruction was suspected. The cat had swelling of the left side of the face, severe periodontal disease and a fractured upper left canine tooth with pulpal exposure. Dacryocystorhinography revealed narrowing of the nasolacrimal duct above the root of the fractured upper left canine and dental radiographs showed a severe periapical lucency at the apex of the upper left canine tooth. The fractured canine tooth was removed. Subsequently, the ocular discharge and facial swelling resolved. After 2 years, the epiphora has never reoccurred. This is a noteworthy case because a suspected root abscess resulted in extralumenal compression of the nasolacrimal duct, which shows the importance of a thorough oral examination when nasolacrimal obstruction is evident.     

Cholesterol granuloma of the maxilla in a dog

A case of cholesterol granuloma of the maxilla is described in a 13-year-old dog presented because of a long history of facial swelling, irritation and epiphora. Plain and contrast radiography indicated an intramaxillary mass with overlying bone destruction unrelated to the nasolacrimal duct. The lesion was excised and all clinical signs resolved.     

Purulent dacryocystitis (nasolacrimal duct drainage) secondary to periapical tooth root infection in a donkey

Periapical tooth disease in the equid has been extensively described. Rostral cheek tooth abscessation usually leads to external facial swelling, and in some cases, nasal drainage. Periapical infection of the caudal cheek teeth usually results in maxillary empyema and sinusitis. This case report describes a donkey with periapical tooth root infection of the left 3rd maxillary premolar (207) diagnosed with computed tomography, which drained exclusively into the adjacent/collateral nasolacrimal duct.     

COMPUTED TOMOGRAPHY-ANATOMY OF THE NORMAL FELINE NASOLACRIMAL DRAINAGE SYSTEM

Computed tomography (CT) of the nasolacrimal drainage system with and without contrast medium (barium sulfate) was used to create an anatomic basis for clinical evaluation in domestic cats. To evaluate and compare the anatomical findings, three casts were carried out and were followed by CT examinations. These CT series were also used for a three-dimensional (3D) reconstruction of the nasolacrimal drainage system within surrounding structures. In noncontrast CT images, osseous structures limiting the nasolacrimal drainage system are easily recognizable. In most cats, this allows the identification of the nasolacrimal drainage system even without contrast enhancement. A distal part of the lacrimal sac adjoins directly to the respiratory mucosa of the nasal cavity without an osseous protection. Thus, this may represent a predilection site for infiltration of adjacent pathologic processes from the nasal cavity onto the lacrimal sac. The nasolacrimal duct begins on level with the maxillary third premolar tooth. The apex of the root of the canine tooth is situated very close to the nasolacrimal duct. This close topographic relation may lead to problems with the nasolacrimal drainage system. In domestic cats the nasolacrimal drainage system consists of a descending and a horizontal part, which form an angle of approximately 90 degrees for unhindered drainage of the lacrimal fluid.     

Suture exostosis causing obstruction of the nasolacrimal duct in three horses

CASE HISTORY Three horses were presented with facial swelling and epiphora.

CLINICAL FINDINGS: All horses had facial swellings and radiographic findings consistent with exostosis at the lacrimomaxillary suture, and ipsilateral epiphora. Positive contrast dacryocystorhinography demonstrated that the site of obstruction of the nasolacrimal duct was located where the duct traverses the lacrimomaxillary suture.

DIAGNOSIS: Lacrimomaxillary suture exostosis.

CLINICAL RELEVANCE: Lacrimomaxillary suture exostosis should be considered as a differential diagnosis in cases of epiphora in horses. Dacryocystorhinography, preferably retrograde and normograde, may be used as an aid to diagnosis.     

The nasolacrimal duct of the mule: Anatomy and clinical considerations

This study investigated the location of the nasolacrimal orifice (NLO) and course of the nasolacrimal duct in the mule using visual examination, gross dissection and computed tomography (dacryocystography [CT‐DCG]) and concluded that the location of the NLO is distinct from that described for horses and donkeys and is easily located, by visual examination alone, within the internal cutaneous tissue of the lateral wall of the external nares. The course of the nasolacrimal duct caudal to the nasal vestibule is similar to that of the horse.     

Suture exostosis with concurrent nasal septum chondrosarcoma in a horse

A 15‐year‐old Hanoverian mare presented with a 10‐day history of facial swelling in the right maxillary and frontal regions, left epiphora and intermittent right epistaxis. Radiographs revealed suture exostosis of both nasofrontal sutures and a deviated and thickened nasal septum. Computed tomography (CT) of the skull revealed exostosis of the nasolacrimal sutures and ducts bilaterally of both nasofrontal sutures and of the right zygomatocomaxillary and lacrimomaxillary sutures. The mid‐to‐caudal aspect of the nasal septum was thickened and had multiple well demarcated hypoattenuated regions within the septum. Histological examination of biopsies taken from the right nasofrontal suture and the nasal septal mass revealed suture exostosis and nasal septum chondrosarcoma. The horse was treated with rest and anti‐inflammatories. The facial swelling and left epiphora were improved at 7 months telephone follow‐up. This report is the first to describe a nasal septum chondrosarcoma in a horse. Additionally, we suggest that the suture exostosis may have developed due to an alteration of the biomechanics of the skull sutures secondary to the septal tumour.     

Management of neck and head injuries.

The horse, a flight animal that is used extensively by man, frequently receives injuries to its neck or head that result mostly from its management and handling. Better facilities, training of the horse, and horsemanship skills of the handler could prevent many of these injuries. Because many body systems can be involved, with potentially major consequences regarding health, performance, and appearance, early recognition of trauma and competent treatment are crucial.Progress has been made in the treatment of some tracheal and esophageal injuries. Severe tracheal trauma and rupture of the esophagus still represent major challenges for the attending veterinarian, however. Lacerations of the head generally heal well, likely because of an abundant blood supply.Thorough yet conservative debridement is necessary, as is accurate reconstruction of the tissues to maintain normal function and an acceptable cosmetic appearance. Fractures of the facial bones can result in complications, such as sequestrum formation, sinusitis, nasolacrimal duct injury,facial deformity, and injury to or entrapment of the globe. An awareness of the treatment methods available can help to diminish the complication rate and to restore a normal or acceptable appearance.     

Calcification associated with the nasolacrimal system of a horse: case report and mineralogic composition

A 12-year-old Paso Fino mare was evaluated for a chronic nasal and ocular discharge. A calcification was identified eroding through the nasal mucosa of the middle meatus. Differential considerations for this mass included dacryolith, nasal calculus, or calcified tooth root abscess. Anatomical location and case history and progression supported a dacryolith. Following removal, the calculus was submitted for mineralogic analysis. The calculus was primarily carbonate hydroxylapatite (Ca10(PO4)3(CO3)3(OH)2) with a minor NaCl halite constituent. Dacryoliths, or nasolacrimal calculi, are an uncommon occurrence in animals, and sparsely reported in humans. The etiopathogenesis of dacryolith formation is unknown. The objective of this article was to report the first case report of an equine nasolacrimal system dacryolith and its mineralogic composition.     

Endoscopic examination of the nasolacrimal duct in ten horses

Reasons for performing study: No endoscopic examination of the nasolacrimal duct has been described before. In contrast with other imaging techniques, endoscopy provides a direct inspection of the intralumen and ductal mucosa in standing sedation. Objectives: To provide a reference against which the endoscopic and clinical features of obstructive nasolacrimal disease in the horse may be compared. Methods: Endoscopic examination of the nasolacrimal duct was performed in 10 French Thoroughbred bay mares with a 3 mm shaft diameter flexible fibrescope. The duct was divided into 3 zones (1, 2 and 3) from the nostril to the lacrimal sac. Results: Endoscopic examination of the nasolacrimal duct appeared to be quite easy to perform in Zones 1 and 2, while the ease or difficulty of examining Zone 3 depended on the weight and size of the horse for the position of the endoscope in the lacrimal canal. Conclusions: Endoscopic inspection has provided the possibility of a novel diagnostic approach to conditions of the nasolacrimal duct in horses. Potential relevance: Endoscopic examination of the nasolacrimal duct could help to diagnose and treat nasolacrimal diseases by performing sample withdrawal and duct irrigation.     

Bilateral intraocular glandular choristomas in a Thoroughbred foal

Intraocular choristomas are rare anomalies in domestic animals and are often associated with multiple ocular malformations. A Thoroughbred foal presented for ocular abnormalities and was diagnosed with microphthalmia, corneal dermoids, severe anterior segment dysgenesis (including glandular choristomas), aphakia, retinal dysplasia, and optic nerve hypoplasia. Morphological, histochemical, and immunohistochemical comparisons were made between ocular choristomatous tissues from this foal and lacrimal gland, third eyelid gland, nasopharynx, trachea, and lacrimal sac/nasolacrimal duct from normal horses. Morphologically the choristomatous tissues (glands and epithelium lining the anterior segment) were most similar to the lacrimal sac. Histochemistry of glandular components found the glands associated with the lacrimal sac/nasolacrimal duct to be serous, as was the glandular intraocular choristomas. Our findings suggest that the origin of intraocular glandular choristomas in this case is from the lacrimal sac.     

MAGNETIC RESONANCE IMAGING OF THE INTRATEMPORAL FACIAL NERVE IN IDIOPATHIC FACIAL PARALYSIS IN THE DOG

The most common cause of peripheral facial nerve paralysis in dogs, in the absence of otitis media, is thought to be idiopathic. Gadolinium-enhanced (Gd) magnetic resonance (MR) imaging has been used to study peripheral facial weakness in humans with a wide variety of disorders, including Bell's palsy, the clinical equivalent of idiopathic facial nerve paralysis in dogs. Gd-MR imaging may be useful to demonstrate abnormal enhancement of the intratemporal facial nerve. The aim of this study was to define the role of the Gd-MR imaging in dogs with idiopathic facial nerve paralysis, with regard to pattern of enhancement, and to search for prognostic information. Six dogs with peripheral facial nerve paralysis, followed between 2003 and 2005, were studied. Physical and neurologic examinations, as well as clinical tests, were performed, including routine hematology, serum biochemistry, thyroid screening, cerebrospinal fluid analysis, and MR imaging. The time interval between the onset of the clinical signs, the progress of the disease, and the final recovery was noted in each dog. The following four intratemporal segments of the facial nerve were analyzed: internal acoustic meatus, labyrinthine segment/geniculate ganglion, tympanic segment, and mastoid segment. Along its length, contrast enhancement was found in four dogs. In this group, contrast enhancement of the facial nerve was found in all segments of two dogs, in three segments of one dog, and in one segment of the other dog. In the four dogs with enhancement, one recovered completely in 8 weeks and three have not recovered completely. The two dogs without evidence of enhancement recovered completely in an average time of 4 weeks.     

Bilateral congenital lacrimal fistula in a Brown Swiss bull

A five-year-old Brown Swiss bull was referred to the Department of Farm Animals, University of Zurich, because of bilateral epiphora that was unresponsive to treatment. Clinical examination revealed a fistulous opening medial to the medial canthus of both eyes and mucopurulent discharge from both openings. Attempts to flush the nasolacrimal duct via the lacrimal points resulted in the fluid exiting via the fistulous opening. Retrograde flushing of the nasolacrimal duct from the nasolacrimal opening resulted in the flush fluid flowing back out the nasolacrimal opening. Bilateral lacrimal fistula medial to the medial canthus of the eye was diagnosed based on the findings. The same anomaly was diagnosed a year later in 4?related female animals referred to our Department for other reasons. Three of the cases were sired by the bull described above and one was sired by his half-brother. Therefore, an autosomal recessive mode of inheritance of this anomaly was assumed. Clinical, epidemiological and molecular studies of the offspring of both bulls are underway to further investigate this anomaly.     

Use of canaliculorhinostomy for repair of nasolacrimal duct obstruction in a horse

Obstruction of the nasolacrimal outflow pathway in horses is not uncommon. Causes of obstruction include foreign bodies, trauma, and congenital abnormalities. Placement of a nasolacrimal retention stylette may prove challenging.     

The course of the nasolacrimal duct in brachycephalic cats

Casts of the nasolacrimal duct system were obtained from 50 euthanised cats including brachy-, meso- and dolichocephalic breeds. The course of the nasolacrimal duct, which was assessed radiographically and gross-anatomically, was strongly related to the shape of the skull. In meso- and dolichocephalic cats the nasolacrimal duct formed a dorsally opened arch with the descending part being directed rostroventrally. The main part of the duct passed the nasal cavity in a rather horizontal course parallel to the hard palate and was located ventrally to the lacrimal foramen. However, foreshortening of the face was associated with a right-angled or even acute-angled alignment of the duct. In higher degrees of brachycephaly the main part of the duct ascended beyond the level of the lacrimal foramen and passed the nasal cavity dorsal to the level of the lacrimal foramen. This specific course of the nasolacrimal duct in brachycephalic cats was consistent with a steeper alignment and attachment of the maxilloturbinate. Accessory orifices of the nasolacrimal duct opening into the nasal cavity had never been observed. The present results strongly suggest that the specific course of the nasolacrimal duct in brachycephalic cats might hinder the drainage of the lacrimal fluid irrespective of the diameter of the lumen of the nasolacrimal duct system.     

A method of surgical correction of glaucoma in a dog

A new surgical technique is described for the attempted relief of glaucoma in a dog. To achieve aqueous drainage a Supramid thread was placed in the anterior chamber, threaded subconjunctival^ across the globe and inserted into the nasolacrimal duct via the dorsal lacrimal punctum. It is hoped that the level of success achieved in this one case will prompt others, to investigate the nasolacrimal duct as a possible drainage route for aqueous fluid.     

Bilateral nasolacrimal duct atresia in a cria

A 2-month-old, male alpaca had a 1-month history of mucoid ocular discharge from the left eye. Signalment, history and clinical findings were suggestive of a congenital nasolacrimal outflow obstruction. A dacryocystorhinogram confirmed bilateral nasolacrimal duct atresia, which involved the distal half of both nasolacrimal ducts. In order to establish alternative outflow, a conjunctivomaxillosinusotomy and conjunctivorhinostomy were performed on the right and left eye, respectively. The surgical openings remain patent after 11 months, and there have been no clinical signs of nasolacrimal disease.     

Anatomic and radiographic study of the lacrimal apparatus of llamas.

The anatomy of the nasolacrimal duct of llamas was examined grossly and radiographically in 2 llamas. Dacryocystorhinography was performed on cadaver heads, using a radiographic aqueous contrast agent. Anatomic casts of the nasolacrimal apparatus were obtained by cannulation of the duct and use of polyurethane cast material. Dacryocystorhinography accurately revealed the nasolacrimal apparatus and compared favorably with gross dissections and polyurethane casts.