Morphometric evaluation of bony nasolacrimal canal in Libyan adults in Benghazi using CT scan
DOI:
https://doi.org/10.54361/LJMR.19.1.10Keywords:
Morphometric, nasolacrimal, variations, interventionsAbstract
Introduction: The nasolacrimal duct (NLD) consists of two segments: one surrounded by the maxillary bone and the other extending from the lacrimal sac to the bony nasolacrimal duct (BNLD) entry. Given its canal-like structure, the narrowest point of the NLD may play a crucial role in primary acquired nasolacrimal duct obstruction (PANDO). This study aimed to assess the anatomical characteristics of the NLD, specifically the proximal and distal bony diameters, as well as the length of the bony nasolacrimal canal, using computed tomography (CT). Additionally, the study sought to determine whether these parameters differ between males and females.
Method: A retrospective analysis was conducted on 413 individuals (145 females and 268 males) randomly selected from Benghazi Medical Center and Aljala Hospital. CT scans were used to measure the anatomical dimensions of the NLD. Data were analyzed using the Statistical Package for the Social Sciences (SPSS), employing t-tests and one-way ANOVA to compare the parameters across genders and age groups, respectively.
Result: The length of the bony nasolacrimal canal was significantly greater in males than in females. However, no significant differences were found between males and females in the proximal and distal diameters of the bony nasolacrimal canal. Age groups showed no significant correlations with the proximal and distal diameters, but a marginally significant correlation was found between age and the length of the bony nasolacrimal canal.
Conclusion : This study offers valuable insights into the anatomical features of the nasolacrimal duct system. It highlights that, while there are no significant differences in the proximal and distal diameters between males and females, the length of the bony nasolacrimal canal is significantly longer in males. These findings enhance our understanding of anatomical variations in the nasolacrimal duct and could inform clinical approaches to managing nasal obstruction in adults.
Downloads
References
Sharma HR, Sharma AK, Sharma R. Modified External Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction. J Clin Diagn Res. 2015 Oct;9(10):NC01-5.
Imre A, Imre SS, Pinar E, Ozkul Y, Songu M, Ece AA, Aladag I. Transection of Nasolacrimal Duct in Endoscopic Medial Maxillectomy: Implication on Epiphora. J Craniofac Surg. 2015 Oct;26(7):e616-9.
McCormick A, Sloan B. The diameter of the nasolacrimal canal measured by computed tomography: gender and racial differences. Clin Exp Ophthalmol. 2009 May;37(4):357-61.
Bartley GB. Acquired lacrimal drainage obstruction: an etiologic classification system, case reports, and a review of the literature. Part 3. Ophthalmic Plast Reconstr Surg. 1993;9(1):11-26. PMID: 8443110.
Hurwitz JJ. Diseases of the sac and duct. In: Hurwitz JJ, editor. The lacrimal system. Philadelphia: Lippincott-Raven; 1996. p. 117–22.
Linberg JV, McCormick SA. Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique. Ophthalmology. 1986 Aug;93(8):1055-63.
Ohtomo K, Ueta T, Toyama T, Nagahara M. Predisposing factors for primary acquired nasolacrimal duct obstruction. Graefes Arch Clin Exp Ophthalmol. 2013 Jul;251(7):1835-9.
Seider N, Miller B, Beiran I. Topical glaucoma therapy as a risk factor for nasolacrimal duct obstruction. Am J Ophthalmol. 2008 Jan;145(1):120-123.
- Lee S, Lee UY, Yang SW, Lee WJ, Kim DH, Youn KH, Kim YS. 3D morphological classification of the nasolacrimal duct: Anatomical study for planning treatment of tear drainage obstruction. Clin Anat. 2021 May;34(4):624-633.
- Čihák R. Anatomy I. 2nd ed. Prague: Grada; 2001. 516 pp. ISBN 978-80-7169-970-5.
- Kassel EE, Schatz CJ. Anatomy, imaging, and pathology of the lacrimal apparatus. In: Som PM, Curtin HD, eds. Head and neck imaging. 5th ed. St. Louis, MO: Elsevier-Mosby; 2011:757–853.
- Okumuş Ö. Investigation of the morphometric features of bony nasolacrimal canal: a cone-beam computed tomography study. Folia Morphol (Warsz). 2020;79(3):588-593.
- Lee H, Ha S, Lee Y, Park M, Baek S. Anatomical and morphometric study of the bony nasolacrimal canal using computed tomography. Ophthalmologica. 2012;227(3):153-159.
- Valencia MRP, Takahashi Y, Naito M, Nakano T, Ikeda H, Kakizaki H. Lacrimal drainage anatomy in the Japanese population. Ann Anat. 2019 May;223:90-99.
- Czyz CN, Bacon TS, Stacey AW, Cahill EN, Costin BR, Karanfilov BI, Cahill KV. Nasolacrimal System Aeration on Computed Tomographic Imaging: Sex and Age Variation. Ophthalmic Plast Reconstr Surg. 2016 Jan-Feb;32(1):11-6.
- Takahashi Y, Nakata K, Miyazaki H, Ichinose A, Kakizaki H. Comparison of bony nasolacrimal canal narrowing with or without primary acquired nasolacrimal duct obstruction in a Japanese population. Ophthalmic Plast Reconstr Surg. 2014 Sep-Oct;30(5):434-8.
- Shigeta K, Takegoshi H, Kikuchi S. Sex and age differences in the bony nasolacrimal canal: an anatomical study. Arch Ophthalmol. 2007 Dec;125(12):1677-81.
- Erçakmak B, Vatansever A, Demiryürek D, Gümeler E. Morphometric evaluation of nasolacrimal duct. Anatomy. 2021 Apr;15(1):64-8.
- Maliborski A, Różycki R. Diagnostic imaging of the nasolacrimal drainage system. Part I. Radiological anatomy of lacrimal pathways. Physiology of tear secretion and tear outflow. Med Sci Monit. 2014 Apr 17;20:628-38.
- Lin Z, Kamath N, Malik A. High-resolution computed tomography assessment of bony nasolacrimal parameters: variations due to age, sex, and facial features. Orbit. 2021 Oct;40(5):364-369.
- Janssen AG, Mansour K, Bos JJ, Castelijns JA. Diameter of the bony lacrimal canal: normal values and values related to nasolacrimal duct obstruction: assessment with CT. AJNR Am J Neuroradiol. 2001 May;22(5):845-50.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Shahed Almashity, Mustafa Karwad, Osama Araibi, Arwa Alfitorey, Abdulaziz Algadi (Author)
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
Open Access Policy
Libyan journal of medical Research (LJMR).is an open journal, therefore there are no fees required for downloading any publication from the journal website by authors, readers, and institution.
The journal applies the license of CC BY (a Creative Commons Attribution 4.0 International license). This license allows authors to keep ownership f the copyright of their papers. But this license permits any user to download , print out, extract, reuse, archive, and distribute the article, so long as appropriate credit is given to the authors and the source of the work.
The license ensures that the article will be available as widely as possible and that the article can be included in any scientific archive.
Editorial Policy
The publication of an article in a peer reviewed journal is an essential model for Libyan journal of medical Research (LJMR). It is necessary to agree upon standards of expected ethical behavior for all parties involved in the act of publishing: the author, the journal editorial, the peer reviewer and the publisher.
Any manuscript or substantial parts of it, submitted to the journal must not be under consideration by any other journal. In general, the manuscript should not have already been published in any journal or other citable form, although it may have been deposited on a preprint server. Authors are required to ensure that no material submitted as part of a manuscript infringes existing copyrights, or the rights of a third party.
Authorship Policy
The manuscript authorship should be limited to those who have made a significant contribution and intellectual input to the research submitted to the journal, including design, performance, interpretation of the reported study, and writing the manuscript. All those who have made significant contributions should be listed as co-authors.
Others who have participated in certain substantive aspects of the manuscript but without intellectual input should only be recognized in the acknowledgements section of the manuscript. Also, one of the authors should be selected as the corresponding author to communicate with the journal and approve the final version of the manuscript for publication in the LJMR.
Peer-review Policy
- All the manuscripts submitted to LJMR will be subjected to the double-blinded peer-review process;
- The manuscript will be reviewed by two suitable experts in the respective subject area.
- Reports of all the reviewers will be considered while deciding on acceptance/revision or rejection of a manuscript.
- Editor-In-Chief will make the final decision, based on the reviewer’s comments.
- Editor-In-Chief can ask one or more advisory board members for their suggestions upon a manuscript, before making the final decision.
- Associate editor and review editors provide administrative support to maintain the integrity of the peer-review process.
- In case, authors challenge the editor’s negative decision with suitable arguments, the manuscript can be sent to one more reviewer and the final decision will be made based upon his recommendations.
