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3D morphometric study of the nasolacrimal duct and its implication in recanalization of nasolacrimal duct obstruction
Author(s) -
Lee Sohyun,
Lee UYoung,
Lee WonJoon,
Kim DongHo,
Seok Nam Yong,
Kim InBeom,
Kim YiSuk
Publication year - 2019
Publication title -
acta ophthalmologica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.534
H-Index - 87
eISSN - 1755-3768
pISSN - 1755-375X
DOI - 10.1111/j.1755-3768.2019.5155
Subject(s) - nasolacrimal duct , coronal plane , anatomy , medicine , nasolacrimal duct obstruction , lacrimal sac , skull , lacrimal apparatus , dacryocystorhinostomy , radiology , surgery
Purposes The nasolacrimal recanalization, consisting of retrograde removal of obstructing tissues using electrocauterization, is an evolutionally developed surgical procedure to treat the nasolacrimal duct (NLD) obstruction. To perform the nasolacrimal recanalization requires an understanding of three‐dimensional (3D) structure of the NLD, but very few data are available about its stereotactic shape. This study aims at investigating the anatomy of the NLD through 3D visualization and metric assessment of 3D models obtained from the cranial CT‐scans. Methods This study included 20 males and 20 females (range: 18–68 years), who underwent autopsy at the National Forensic Service Seoul Institute, Seoul, Korea. Post‐mortem cranial CT‐scans were achieved in helical mode with slice thickness of 0.75 mm and 120 kV. 3D models of the NLD were reconstructed from serial CT slices after performing semi‐automated segmentation by tracing and filling the outline of the nasolacrimal duct by Mimics software (version 20.0, Materialise, Leuven, Belgium). Results Overall length of NLD, anteroposterior and transverse entrance diameters of bony NLD (BNLD), and lacrimal sac‐BNLD angle was significantly higher in males than females. Compared with right and left, most variables showed no significant differences in statistics, except for lacrimal sac‐BNLD angle. BNLD orientation type in coronal plane showed outward type than inward by over 80%. Collectively, the whole appearance of the NLD was shaped like a bowleg in which the distal part is relatively turned inward. Conclusion These results suggest that 3D models of the NLD were crucial for understanding structural recognition, mainly related to model‐based image analysis, and useful to aid in the surgical procedure and treatment of the nasolacrimal duct obstruction. The authors wish to acknowledge the financial support of the Catholic Medical Center Research Foundation made in the program year of 2019 (No. 552019B000100003).