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Tears are produced by the lacrimal gland, situated just outside the eye. Blinking the eyelids distributes the tears to keep the eyes moist, clean and lubricated. Excess tears are drained via the punctum through the tiny channels called canaliculi located on the inner side of the eyes into the tear sac, from there to the tear duct, the nose and finally down the throat.
A dacryoadenectomy is the surgical removal of a lacrimal gland. [8] A dacryocystectomy is the surgical removal of a part of the lacrimal sac. [8] A dacryocystorhinostomy (DCR) or dacryocystorhinotomy is a procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function. [8] [11]
Involutional stenosis is probably the most common cause of nasolacrimal duct obstruction in older people. It affects women twice as frequently as men. Although the inciting event in this process is unknown, clinicopathologic study suggests that compression of the lumen of the nasolacrimal duct is caused by inflammatory infiltrates and edema.
The lacrimal gland is a compound tubuloacinar gland, it is made up of many lobules separated by connective tissue, each lobule contains many acini.The acini composed of large serous cells which, produce a watery serous secretion, serous cells are filled with lightly stained secretory granules and surrounded by well-developed myoepithelial cells and a sparse, vascular stroma.
The lacrimal apparatus is the physiological system containing the orbital structures for tear production and drainage. [1]It consists of: The lacrimal gland, which secretes the tears, and its excretory ducts, which convey the fluid to the surface of the eye; it is a j-shaped serous gland located in lacrimal fossa.
The canal containing the duct is called the nasolacrimal canal.It is formed by indentations in the inferior nasal conchae, maxilla and lacrimal bone.The canal drains into the nasal cavity through the anterior portion of the inferior meatus, which is between the inferior concha and the floor of the nasal cavity.
There are two types of plastic surgery used – reconstructive surgery that restores the form and functions of the nose and cosmetic surgery that changes the appearance of the nose. Reconstructive surgery seeks to resolve nasal injuries caused by various traumas including blunt , and penetrating trauma and trauma caused by blast injury .
It attaches to the frontal process of the maxilla, the lacrimal groove, and the tarsus of each eyelid. It has a superficial (anterior) and a deep (posterior) layer, with many surrounding attachments. It connects the medial canthus of each eyelid to the medial part of the orbit. It is a useful point of fixation during eyelid reconstructive surgery.