Anatomical Parameters of The Nasolacrimal Duct in Children {Up West} Measured with Computed Tomography
DOI:
https://doi.org/10.63682/jns.v14i32S.7411Keywords:
Nasolacrimal duct (NLD), Congenital nasolacrimal duct obstruction (CNLDO), Multidetector computed tomography (MDCT), Magnetic resonance imaging (MRI), Dacryocystorhinostomy (DCR), Tear drainage, Pediatric anatomy, Lacrimal system, Anatomical variationsAbstract
The nasolacrimal duct (NLD) plays a crucial role in tear drainage from the ocular surface to the nasal cavity, and its anatomical variations in children are of significant clinical relevance, particularly in the context of congenital nasolacrimal duct obstruction (CNLDO). This study aims to evaluate the normative anatomical parameters of the NLD in the pediatric population using high-resolution imaging modalities, including multidetector computed tomography (MDCT) and magnetic resonance imaging (MRI). Key parameters assessed include NLD length, diameter, angulation, and the morphology of the nasolacrimal canal.
A retrospective analysis was conducted on imaging data from paediatric patients aged 0–20 years who underwent head CT scans for non-lacrimal indications. The NLD was visualized in axial and sagittal planes, and measurements were stratified by age and gender. The study revealed that NLD length and diameter increased progressively with age, with statistically significant differences noted between age groups. No significant gender differences were found in most parameters. The angle of the NLD relative to the nasal floor was also found to vary slightly with age, which may potentially influence tear flow dynamics.
These findings establish normative reference values for NLD dimensions in children and enhance understanding of age-related anatomical development. The data have important implications for the diagnosis and management of CNLDO and for planning pediatric dacryocystorhinostomy (DCR) procedures. Further prospective studies with larger cohorts are recommended to validate these findings and explore ethnic or population-based variations.
Downloads
Metrics
References
Gupta N. Endoscopic Dacryocystorhinostomy. Singapore: Springer Singapore; 2021.
Ali MJ. Ultrastructural Anatomy of Normal Lacrimal Drainage System. In: Atlas of Lacrimal Drainage Disorders. Singapore: Springer Nature Singapore; 2023. p. 65–84.
Ali MJ, Baig F, Lakshman M, Naik MN. Scanning Electron Microscopic Features of the External and Internal Surfaces of Normal Adult Lacrimal Drainage System. Ophthalmic Plast Reconstr Surg. 2015 Sep;31(5):414–7.
Gupta N. Anatomy of Lacrimal Drainage System. In: Endoscopic Dacryocystorhinostomy. Singapore: Springer Singapore; 2021. p. 9–21.
MORE THAN A TEXTBOOK! [Internet]. Available from:
http://evolve.elsevier.com/Seeram/YOU’VEJUSTPURCHASED
Sathiamoorthi S, Frank RD, Mohney BG. Incidence and clinical characteristics of congenital nasolacrimal duct obstruction. British Journal of Ophthalmology. 2019 Apr;103(4):527–9.
Czyz C, Bacon T, Stacey A, Cahill E, Karanfilov B, Cahill K, et al. Nasolacrimal system aeration on computed tomographic imaging: effects of patient positioning and scan orientation. Clinical Ophthalmology. 2015 Mar;469.
Measuring nasolacrimal duct volume using computed tomography images in nasolacrimal duct obstruction patients in Korean. Int J Ophthalmol. 2019 Jan 18;
Zhang S, Cheng Y, Xie J, Wang Z, Zhang F, Chen L, et al. Anatomical Study and Locating Nasolacrimal Duct on Computed Topographic Image. Journal of Craniofacial Surgery. 2017 Jan;28(1):275–9.
Ali MJ, Patnaik S, Kelkar N, Ali MH, Kaur I. Alteration of Tear Cytokine Expressions in Primary Acquired Nasolacrimal Duct Obstruction–Potential Insights into the Etiopathogenesis. Curr Eye Res. 2020 Apr 2;45(4):435–9.
F Tasneem A, Vittal Nayak I, H Rao S, Niharika Prasad S, Nargis N. An observational study on nasolacrimal duct probing in catarrhal stage of chronic dacrocystitis in Indian population. IP International Journal of Ocular Oncology and Oculoplasty. 2020 Sep 28;6(3):196–9.
Told R, Pichler A, Lackner B, Kuchar A, Schmidt-Erfurth U, Dunavölgyi R. Retrospective analysis of congenital nasolacrimal duct obstruction outcomes in a tertiary referral center. Spektrum der Augenheilkunde. 2022 Dec 8;36(6):166–72.
Yang MK, Sa HS, Kim N, Kim JH, Choung H, Khwarg SI. Bony nasolacrimal duct size and outcomes of nasolacrimal silicone intubation for incomplete primary acquired nasolacrimal duct obstruction. PLoS One. 2022 Mar 28;17(3):e0266040.
Vagge A, Ferro Desideri L, Nucci P, Serafino M, Giannaccare G, Lembo A, et al. Congenital Nasolacrimal Duct Obstruction (CNLDO): A Review. Diseases. 2018 Oct 22;6(4):96.
Sagiv OY, Nemet A, Achiron A, Neumann D, Tuuminen R, Spierer O. Outcomes of Congenital Nasolacrimal Duct Obstruction Surgery Converted into Balloon Dilation and Silicone Intubation due to Probing Difficulty. J Ophthalmol. 2022 Mar 12;2022:1–6.
Iovănescu G, Pop LL, Vintilă DR, Marin KC, Mogoantă CA, Lăzureanu DC, et al. Nasal polyposis from cystic fibrosis in children – the experience of a single center. Romanian Journal of Morphology and Embryology. 2023 Aug 1;64(2):235–40.
Raslan OA, Ozturk A, Pham N, Chang J, Strong EB, Bobinski M. A Comprehensive Review of Cross-Sectional Imaging of the Nasolacrimal Drainage Apparatus: What Radiologists Need to Know. American Journal of Roentgenology. 2019 Dec;213(6):1331–40.
Bansal O, Bothra N, Sharma A, Walvekar P, Ali MJ. Congenital nasolacrimal duct obstruction update study (CUP study): paper I—role and outcomes of Crigler’s lacrimal sac compression. Eye. 2021 Jun 10;35(6):1600–4.
Miller AM, Chandler DL, Repka MX, Hoover DL, Lee KA, Melia M, et al. Office probing for treatment of nasolacrimal duct obstruction in infants. Journal of American Association for Pediatric Ophthalmology and Strabismus. 2014 Feb;18(1):26–30.
Limongi RM, Magacho L, Matayoshi S, Carneiro HM, Ávila M. Computed tomographic dacryocystography in children undergoing balloon dacryoplasty. Journal of American Association for Pediatric Ophthalmology and Strabismus. 2012 Oct;16(5):464–7.
Castelijns JA, Janssen AG, Mansour K, Bos JJ. with CT Nasolacrimal Duct Obstruction: Assessment Normal Values and Values Related to Diameter of the Bony Lacrimal Canal: Diameter of the Bony Lacrimal Canal: Normal Values and Values Related to Nasolacrimal Duct Obstruction: Assessment with CT [Internet]. Vol. 22, AJNR Am J Neuroradiol. 2024. Available from: http://www.ajnr.org/content/22/5/
Weiss AH, Baran F, Kelly J. Congenital Nasolacrimal Duct Obstruction. Archives of Ophthalmology. 2012 Jul 1;130(7).
Saini M, Bajaj MS, Pushker N, Meel R, Saini K, Chaurasia S, et al. Evaluation of lacrimal duct probing in adults with 0.02% and 0.04% mitomycin-C in primary acquired nasolacrimal duct obstruction. Oman J Ophthalmol. 2022 Jan;15(1):56–60.
Makselis A, Petroska D, Kadziauskiene A, Jaruseviciene R, Ruzgys A, Cimbalas A, et al. Acquired nasolacrimal duct obstruction: clinical and histological findings of 275 cases. BMC Ophthalmol. 2022 Dec 5;22(1):12.
Altınkaynak H. Anatomical Parameters of Nasolacrimal Duct Evaluated by Computed Tomography in Healthy Children. Beyoglu Eye Journal. 2019;
Downloads
Published
How to Cite
Issue
Section
License
This work is licensed under a Creative Commons Attribution 4.0 International License.
You are free to:
- Share — copy and redistribute the material in any medium or format
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
Terms:
- Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
