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.     

The relief of epiphora by conjunctivorhinostomy

A technique of conjunctivorhinostomy is described for the relief of epiphora in the absence of satisfactory lachrymal drainage. The method employed involves implanting a polythene tube from the mesial canthus to the maxillary sinus to create a permanent fistula.     

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.     

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.     

Hydronephrosis and pyelonephritis associated with an anomalous vas deferens in a bull

Hydronephrosis and pyelonephritis were diagnosed in a 2-year-old Limousin bull. Salient historical and clinical observations included weight loss, anorexia, intermittent colic, polyuria, polydypsia, and an ammoniacal breath odor. Intravenous treatment with fluids and antibiotics did not induce a favorable response. An anomalous vas deferens was observed on postmortem examination. The vas deferens ended in a blind polyp that protruded into the lumen of the urethra. This polyp may have caused chronic intermittent obstruction, predisposing to the hydronephrosis and pyelonephritis.     

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.     

Intraosseous approach to the nasolacrimal duct for removal of a foreign body in a dog

A Labrador retriever was evaluated because of chronic mucopurulent discharge from the left eye. A foreign body was identified in the nasolacrimal duct by use of dacryocystorhinography. Attempts to alleviate the inflammation by use of flushing and administration of antimicrobials were unsuccessful. At surgery, the infraorbital foramen was used as a landmark for a skin incision, because the nasolacrimal duct courses dorsal and parallel to the infraorbital canal. An air drill was used to remove the portion of the maxillary bone overlying the nasolacrimal duct, which exposed the intraosseous portion of the duct and allowed removal of a plant-material foreign body. The incision in the duct was allowed to heal by second intention, and the dog recovered without complications.     

Endoscopic-guided diagnosis of and interventional stent placement for nasolacrimal duct obstruction in a horse

Objective

To describe the successful use of endoscopy to visualize and place a soft canine ureteral stent to relieve a chronic nasolacrimal duct (NLD) obstruction in a horse.

Animal Studied

A 7-year-old, Quarter horse gelding.

Procedure

Under general anesthesia, retrograde nasolacrimal endoscopy was performed using an 8.5 Fr Storz Flex XC ureteroscope through the nasal punctum (NP). An obstructive web of fibrous tissue was visualized approximately 20 cm proximal to the NP. A 0.035″/150 cm hydrophilic guidewire was passed normograde from the ventral lacrimal punctum and used to puncture the stenotic tissue. Then, a 5.0Fr/70 cm open-end ureteral catheter was threaded normograde over the guidewire and NLD patency was re-established. The catheter confirmed a NLD length of 30 cm and was then removed. A 5.0Fr/22–32 cm Universa© Soft Ureteral Stent was threaded normograde over the guidewire until the loops of the stent were exposed at each end. The guidewire was removed and the stent loops were sutured in place.

Results

The stent was withdrawn 1 month after the procedure. Telephone follow-up with the client reported significant improvement in the amount of ocular discharge and decreased sensitivity around the face and ears.

Conclusion

Endoscopy is a safe and effective procedure allowing for definitive diagnosis of NLD obstruction and to assist in interventional procedures. Placement of a canine indwelling ureteral stent seems to be an effective alternative treatment option for equine NLD obstruction compared to conventional invasive surgical procedures.     

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.     

Surgical treatment of recurrent dacryocystitis secondary to cystic dilatation of the nasolacrimal duct in a dog

A 3-year-old, castrated male golden retriever was presented for evaluation of recurrent ocular discharge of 4 months' duration from the left eye. Dacryocystorhinography was performed and demarcated a cystic dilatation of the left nasolacrimal duct with obstruction of the duct distal to the cystic cavity. Surgical exploration of the left maxillary sinus was performed to confirm the diagnosis and reestablish drainage into the nasal cavity. Recovery was uneventful, and the dog has been asymptomatic for >36 months postoperatively. This report documents the third published case of surgical treatment for cystic dilatation of the nasolacrimal duct.     

Radiographic and gross anatomy of the nasolacrimal duct of the horse

The anatomy of the nasolacrimal duct of the horse was studied grossly and radiographically, using barium contrast dacryocystorhinography and methyl methacrylate casts. Radiographic contrast studies were performed on 4 specimens and gross dissections were performed on 6 specimens. Dacryocystorhinography accurately delineated the course of the nasolacrimal duct, as was subsequently demonstrated by gross dissection. A 60% barium sulfate suspension produced good radiographic contrast, allowing critical assessment of the anatomic features of the nasolacrimal duct.     

Repair of a salivary duct fistula in a horse without using a stent

A salivary duct fistula in a horse was repaired surgically without using a stent. Seventeen months after the operation the skin incision had healed without complications and the fistula had not recurred.     

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.     

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.