Surgical anatomy of the nasolacrimal duct on the lateral nasal wall as revealed by serial dissections

• Published in: Anatomical science international 2010-03, Vol.85 (1), p.8-12
• Main Authors: Tatlisumak, Ertugrul, Aslan, Asim, Cömert, Ayhan, Ozlugedik, Samet, Acar, Halil Ibrahim, Tekdemir, Ibrahim
• Format: Article
• Language: English
• Subjects: Adult; Anatomy; Anatomy & physiology; Animal Anatomy; Animal Physiology; Cell Biology; Dacryocystorhinostomy; Dissection; Female; Histology; Human body; Human Physiology; Humans; Male; Medicine; Medicine & Public Health; Morphology; Nasal Cavity - anatomy & histology; Nasal Cavity - surgery; Nasolacrimal Duct - anatomy & histology; Nasolacrimal Duct - surgery; Neurosciences; Nose; Original Article; Surgery
• ISSN: 1447-6959; 1447-073X
• DOI: 10.1007/s12565-009-0044-z

The anatomy of the nasolacrimal duct (NLD) in relation with the lateral nasal wall was studied in 15 half-heads of human adult cadavers by serial photographs of the dissection of the lateral nasal wall. The aim of the study was to determine the intranasal anatomical relationships of the NLD with the lateral nasal wall for surgical reference during endoscopic dacryocystorhinostomy. Following removal of the nasal mucosa anterior to the uncinate process, the exposed bone was removed by drilling. The entire NLD was exposed intranasally. The relationships of the NLD with the maxillary sinus ostium and anterior nasal spine were determined, and the length of the NLD was measured. The morphology of the NLD opening was observed, and its distance from several landmarks were measured. There were three types of intranasal orifice: pin-point, triangular and slit-like. The NLD is located, on average, 24.6 ± 3.56 mm posterior to the anterior nasal spine. The nearest distances between the opening of the NLD and the nasal floor and between the opening of the NLD and the most anterior attachment of the inferior nasal concha were 13.7 ± 3.15 and 14.3 ± 2.05 mm, respectively. The length of the NLD was 21.9 ± 2.03 mm on average. The nearest distances between the NLD and the maxillary sinus ostium was 3.9 ± 0.88 mm. Cadaver dissections and the photographs of the fine dissections provide a more accurate description of the lateral nasal wall anatomy. These data provide valuable anatomical information to the surgeon performing endonasal dacryocystorhinostomy.