Overview
Infestation by Calliphora, commonly known as blowfly infestation, involves larvae feeding on necrotic tissue, often seen in neglected wounds or post-traumatic conditions, leading to tissue damage and potential systemic complications [Not directly covered in provided abstracts].Diagnosis
Clinical Presentation: Epiphora (excessive tearing) may indirectly suggest underlying nasolacrimal system issues 1.
Diagnostic Tests:
- Nasal Endoscopy: Identifies cysts or obstructions at the nasolacrimal duct orifice 1.
- Lacrimal Drainage Function Tests: Fluorescein dye disappearance test and drop test assess tear drainage capacity 2.Management
Surgical Interventions:
- Endoscopic Resection: For cysts obstructing the nasolacrimal duct orifice 1.
- Dacryocystoplasty with Balloon Dilation: Minimally invasive radiologic procedure for nasolacrimal duct dilation 3.
Reconstructive Techniques:
- Silastic Intubation: For absent or dysfunctional lacrimal puncta to ensure patency 4.Special Populations
Pediatrics: Nasolacrimal duct cysts described in neonates but not in adults 1.
Elderly: Decreased lacrimal drainage capacity noted with age in diagnostic tests 2.Key Recommendations
Endoscopic Identification and Resection of Cysts: For adults presenting with epiphora due to nasolacrimal duct orifice cysts 1 (Evidence: Moderate).
Consider Dacryocystoplasty with Balloon Dilation: As a less invasive alternative for patients with epiphora due to nasolacrimal duct obstruction 3 (Evidence: Weak).
Use Silastic Intubation for Absent Puncta: To enhance lacrimal passage patency in cases of absent or dysfunctional lacrimal puncta 4 (Evidence: Expert opinion).References
1 DelGaudio JM, Wojno T. Nasolacrimal duct orifice cysts in adults: a previously unrecognized, easily treatable cause of epiphora. The Laryngoscope 2007. link
2 Sahlin S, Chen E. Evaluation of the lacrimal drainage function by the drop test. American journal of ophthalmology 1996. link70490-8)
3 Munk PL, Lin DT, Morris DC. Epiphora: treatment by means of dacryocystoplasty with balloon dilation of the nasolacrimal drainage apparatus. Radiology 1990. link
4 Putterman AM. Reconstruction of absent lacrimal puncta. Ophthalmic surgery 1979. link