Introduction: Congenital nasolacrimal duct obstruction with facial malformation may accompany atresia of the nasolacrimal duct. We report a case of congenital bony obstruction of the nasolacrimal duct with cleft lip and palate.
Case: A 2-year-old boy with obstruction of both lacrimal system. Computed tomography (CT) showed lacrimal system aplasia on the right side, and bony obstruction of the nasolacrimal duct on the left side. The patient had a history of cleft lip and palate. We performed external dacryocystorhinostomy (EX-DCR) at 6 years of age because he developed dacryocystitis. We performed EX-DCR again at 8 years of age and endonasal DCR (EN-DCR) at 9 years of age due to recurrence. At the time of writing, 6 years after the last surgery, his postoperative course is excellent.
Conclusions: Epiphora with cleft lip and palate may suggest the possibility of the atresia of the nasolacrimal duct. Congenital bony obstruction of the nasolacrimal duct with facial malformation may recur postoperatively after DCR due to nasal hypoplasia, which should be followed up for a long period.
Nippon Ganka Gakkai Zasshi (J Jpn Ophthalmol Soc) 117: 433-437, 2013.