Foreign body in the right nasal cavity secondary to embedded dacryocystorhinostomy tube
Keywords:Dacryocystitis, DCR, Granuloma, Rhinology, Ophthalmology
A 39-year-old male patient was presented with foreign body sensation eight months post unilateral dacryocystorhinostomy (DCR) tube procedure in his right lower Punctum. On examination, the (silicon-based stent) was patent on the right orbital Punctum. However, the nasal element of the DCR tube was undetected during examination using the nasal speculum. endoscopic examination of the nasal cavity failed to reveal the nasal portion of the tube. None of the approaches performed were successful to detect the exact site of the stent. Therefore, the patient was transferred to the theatre to remove the tube surgically under general anaesthesia. In the operating table, endoscopic examination of the right nasal cavity revealed a granuloma over the nasal portion of the tube, embedded in the lateral nasal wall. Accordingly, the granuloma was then suctioned, which led to the appearance of the DCR tube. The tube was then removed, and the patient established a patent nasal airway. The patient was discharged on the same day, with no postoperative complication. As per the presented case, the following case report will be discussing the potential causes that might have led to the granuloma formation. We aim in the analysis of this case to scale down post DCR procedure complications by comparing the efficacy of silicon-based stents to other type of stents, as to guide surgeons into a safer and lesser invasive approach. In the majority of complicated DCR procedures with granuloma formation, the granulomas are suctioned in a clinical setting. However, the patient needed a more invasive approach, by removing the granuloma surgically to establish a patent nasal airway.
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