Publication:

Iatrogenic nasolacrimal duct obstruction: an unforeseen outcome of naso-orbito-ethmoid fracture surgery

Nasolacrimal duct obstruction can arise as a complication following naso-orbito-ethmoid (NOE) fractures, either due to bone fragments affecting the lacrimal apparatus or as a result of improperly placed implants during reconstructive surgeries. This case report describes a patient who underwent surgery for an NOE fracture with the placement of screws and plates, subsequently presenting with epiphora. The patient underwent endoscopic dacryocystorhinostomy (EDCR) without prior radiological imaging, and a screw was identified in the lacrimal bone during the procedure. Given that radiological imaging is not routinely conducted in all patients scheduled for EDCR, this report discusses the importance of preoperative imaging, particularly for patients with a history of orbital facial reconstruction. The potential benefits of prophylactic silicone stent intubation in patients with orbital facial injuries are also explored.