Bilateral Epiphora as Only Presenting Sign of Total Paranasal Sinus Aplasia

Bilateral Epiphora as Only Presenting Sign of Total Paranasal Sinus Aplasia:

A 20-year-old female patient was presented with a bilateral epiphora. She had no history of infection or trauma related to the sinus areas. On examination, her facial appearance was abnormal and fullness on the face was observed. The fluorescein dye disappearance test was positive in both eyes. The lacrimal system irrigation was patent nasolacrimal duct. However, the dacryoscintigraphy imaging scan demonstrated bilateral obstruction at the nasolacrimal duct-inferior meatus junction. Nasal endoscopy did not reveal any pathologic findings, and lateral nasal wall, septum, and nasal cavities were normal. The patient was referred to the radiology department for a computed tomography of the paranasal sinus as a preoperative diagnostic imaging for lacrimal intervention. Computed tomography revealed the absence of all paranasal sinuses on both sides as well as absence of the ostiomeatal complex and ethmoidal air cells. Both bony lacrimal canal was narrow. Epiphora may be initial sign of total paranasal sinus aplasia. Address correspondence and reprint requests to Mehmet Serhat Mangan, MD, FEBOphth, University of Health Sciences, Haydarpasa Numune Education and Research Hospital, Sadik Eratik Eye Clinic, Tibbiye Cad. No: 23, Uskudar, Istanbul 34668, Turkey; E-mail: mehmetsmangan@yahoo.com Received 1 August, 2020 Accepted 26 August, 2020 The authors report no conflicts of interest. © 2020 by Mutaz B. Habal, MD.