Frequently epiphora is a troublesome symptom from the physician's as well as the patient's point of view. Quite naturally a person suffering from tearing seeks the advice of an ophthalmologist, but in many cases it is also necessary to consult a rhinologist.
It is true that in the majority of cases the tearing results from local stenosis of the lacrimal duct, but not infrequently the cause is to be found in the nose. In these cases treatment with mild anesthetics or astringents or dilation by means of probes is not sufficient.
From the rhinologic standpoint, swelling or polypoidal thickening just under the anterior end of the inferior turbinate is liable to produce tearing. In other words, any mechanical obstruction at the nasal end of the lacrimal duct is of particular interest to the rhinologist.
To summarize the anatomy:
A normal nasolacrimal passageway presents the following:
The two lacrimal canaliculi,
TREMBLE GE. EPIPHORA OF NASAL ORIGIN: A SIMPLE METHOD OF TREATMENT. Arch Otolaryngol. 1944;40(6):494–496. doi:10.1001/archotol.1944.00680020624009
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