Dacryocystography: an old shoe that still fits. Its usefulness a century after the discovery.

Congress:

ECR 2020

Poster Number:

C-04821

Type:

Educational Exhibit

Keywords:

Not applicable, Trauma, Obstruction / Occlusion, Inflammation, Dacryocystography, Digital radiography, Head and neck, Eyes, Contrast agents, Head and Neck

Authors:

M. Novaes¹, M. D. Garboggini², P. C. S. Leite², I. B. Maia², F. D. S. Barros²; ¹SALVADOR, Bahia/BR, ²Salvador/BR

DOI:

10.26044/ecr2020/C-04821

DOI-Link:

https://dx.doi.org/10.26044/ecr2020/C-04821

Fig. 1: Dacryocystogram catheters making materials.

Fig. 3: Fig.3: Catheters in place and fixed to the skin of the frontal region.

Fig. 12: Dacryoliths in Two different patients. A (oblique view) and B (frontal view): a...

Learning objectives

To show a simple Dacryocystography (DCG) technic using an oil-based contrast agent that we have been using for 30 years. To demonstrate the lacrimal pathway anatomy andmake radiologists familiar with the most common imaging aspects of the major pathologies of the lacrimal pathways.

Background

Epiphora is the most common clinical complaint leading to investigation of the lacrimal pathways. Tearing can have two main causes: excessive lacrimation (functional cause) or lack of adequate drainage (anatomical cause), the latter being the most common[4]. Ewing performed the first DCG in 1909 using an oily preparation of bismuth to outline a lacrimal sac abcess[3]. DCG is the cheapest and most available method to demonstrate the anatomical structures of the lacrimal pathway elucidating the cause of epiphora. Delivery of ionizing radiation does occur with...

Findings and procedure details

EQUIPMENT: A conventional digital X-ray equipment consisting of a X-ray tube and Bucky table. No fluoroscopy required. MATERIALS: A Short-acting topical ophthalmic anesthetic (Proxymethacaine Hydrochloride 0.5%) - 2 drops in each eye. 2 Dacryocystogram catheters. See below how to easily make it. Gauze pads. Cotton balls. Oil-based contrast agent (Lipiodol®);1.5 ml for each lacrimal apparatus. Two 3 ml syringes. Adhesive tape to fix the catheters in the skin. CATHETER MAKING MATERIALS:(Fig.1) Two 27-gauge venous access catheters. One straight Kelly tweezers. One scissors. One 10ml syringe....

Conclusion

Dacryocystography is a cheap, safe, widely available and effective exam for assessing patients with epiphora and other lacrimal system complaints. In most cases, it is possible to uncover the existence or not of an obstructive cause, as well as its location, allowing better therapeutic planning.

Personal information and conflict of interest

M. Novaes; Salvador, BAHIA/BR - nothing to disclose M. D. Garboggini; Salvador/BR - nothing to disclose P. C. S. Leite; Salvador/BR - nothing to disclose I. B. Maia; Salvador/BR - nothing to disclose F. D. S. Barros; Salvador/BR - nothing to disclose

References

1.Manfrè L, de Maria M, Todaro E, Mangiameli A, Ponte F, Lagalla R. MR Dacryocystography: Comparison with Dacryocystography and CT Dacryocystography. ANJR 2000;21:1145-1150. 2.Singh S, Ali MJ, Paulsen F. Dacryocystography: From theory to Current practice. Annals of Anatomy 2019;224:33-40. 3.Rodriguez HP, Kittleson AC. Distension Dacryocystography. Radiology Nov 1973;109:317-321. 4.Saleh GM, Gauba V, Tsangaris P, Tharmaseelan K. Digital Subtraction Dacryocystography and Syringing in the Management of Epiphora. Orbit 2007;26:249-253. 5.Som TM, Curtin HD. Head and Neck Imaging. Volume 2. Part V. Chapter 23, page 1129-1181. 6.Munk...