Nasolacrimal duct

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Nasolacrimal duct
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The lacrimal apparatus. Right side.
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Outline of bones of face, showing position of air sinuses.
Details
Identifiers
Latin ductus nasolacrimalis
MeSH D009301
TA98 A15.2.07.070
TA2 6859
FMA 9703
Anatomical terminology

The nasolacrimal duct (also called the tear duct) carries tears from the lacrimal sac of the eye into the nasal cavity. [1] [2] The duct begins in the eye socket between the maxillary and lacrimal bones, from where it passes downwards and backwards. The opening of the nasolacrimal duct into the inferior nasal meatus of the nasal cavity is partially covered by a mucosal fold (valve of Hasner or plica lacrimalis). [3]

Contents

Excess tears flow through the nasolacrimal duct which drains into the inferior nasal meatus. This is the reason the nose starts to run when a person is crying or has watery eyes from an allergy, and why one can sometimes taste eye drops. This is for the same reason when applying some eye drops it is often advised to close the nasolacrimal duct by pressing it with a finger to prevent the medicine from escaping the eye and having unwanted side effects elsewhere in the body as it will proceed through the canal to the nasal cavity.

Like the lacrimal sac, the duct is lined by stratified columnar epithelium containing mucus-secreting goblet cells, and is surrounded by connective tissue.

Clinical significance

Obstruction of the nasolacrimal duct may occur. [4] [5] [6] This leads to the excess overflow of tears called epiphora (chronic low-grade nasolacrimal duct occlusion). [7] A congenital obstruction can cause cystic expansion of the duct and is called a dacryocystocele or Timo cyst. Persons with dry eye conditions can be fitted with punctal plugs that seal the ducts to limit the amount of fluid drainage and retain moisture.

During an ear infection, excess mucus may drain through the nasolacrimal duct in the opposite way tears drain. [ citation needed ]

The canal containing the nasolacrimal duct is called the nasolacrimal canal.

In humans, the tear ducts in males tend to be larger than the ones in females. [8]

Additional image

See also

Related Research Articles

A body orifice is any opening in the body of an animal.

<span class="mw-page-title-main">Lacrimal bone</span> Smallest and most fragile bone of the human skull and face

The lacrimal bone is a small and fragile bone of the facial skeleton; it is roughly the size of the little fingernail. It is situated at the front part of the medial wall of the orbit. It has two surfaces and four borders. Several bony landmarks of the lacrimal bone function in the process of lacrimation or crying. Specifically, the lacrimal bone helps form the nasolacrimal canal necessary for tear translocation. A depression on the anterior inferior portion of the bone, the lacrimal fossa, houses the membranous lacrimal sac. Tears or lacrimal fluid, from the lacrimal glands, collect in this sac during excessive lacrimation. The fluid then flows through the nasolacrimal duct and into the nasopharynx. This drainage results in what is commonly referred to a runny nose during excessive crying or tear production. Injury or fracture of the lacrimal bone can result in posttraumatic obstruction of the lacrimal pathways.

<span class="mw-page-title-main">Inferior nasal concha</span> Facial bone

The inferior nasal concha is one of the three paired nasal conchae in the nose. It extends horizontally along the lateral wall of the nasal cavity and consists of a lamina of spongy bone, curled upon itself like a scroll,. The inferior nasal conchae are considered a pair of facial bones. As the air passes through the turbinates, the air is churned against these mucosa-lined bones in order to receive warmth, moisture and cleansing. Superior to inferior nasal concha are the middle nasal concha and superior nasal concha which both arise from the ethmoid bone, of the cranial portion of the skull. Hence, these two are considered as a part of the cranial bones.

<span class="mw-page-title-main">Orbit (anatomy)</span> Cavity or socket of the skull in which the eye and its appendages are situated

In anatomy, the orbit is the cavity or socket/hole of the skull in which the eye and its appendages are situated. "Orbit" can refer to the bony socket, or it can also be used to imply the contents. In the adult human, the volume of the orbit is 30 millilitres, of which the eye occupies 6.5 ml. The orbital contents comprise the eye, the orbital and retrobulbar fascia, extraocular muscles, cranial nerves II, III, IV, V, and VI, blood vessels, fat, the lacrimal gland with its sac and duct, the eyelids, medial and lateral palpebral ligaments, cheek ligaments, the suspensory ligament, septum, ciliary ganglion and short ciliary nerves.

<span class="mw-page-title-main">Nasolacrimal canal</span>

The canal containing the nasolacrimal duct is called the nasolacrimal canal.

<span class="mw-page-title-main">Lacrimal apparatus</span> Physiological system containing the orbital structures for tear production and drainage

The lacrimal apparatus is the physiological system containing the orbital structures for tear production and drainage.
It consists of:

<span class="mw-page-title-main">Lacrimal canaliculi</span> Small channels in each eyelid that drain lacrimal fluid

The lacrimal canaliculi are the small channels in each eyelid that drain lacrimal fluid, from the lacrimal puncta to the lacrimal sac. This forms part of the lacrimal apparatus that drains lacrimal fluid from the surface of the eye to the nasal cavity.

<span class="mw-page-title-main">Lacrimal sac</span> Upper, dilated end of the nasolacrimal duct

The lacrimal sac or lachrymal sac is the upper dilated end of the nasolacrimal duct, and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla. It connects the lacrimal canaliculi, which drain tears from the eye's surface, and the nasolacrimal duct, which conveys this fluid into the nasal cavity. Lacrimal sac occlusion leads to dacryocystitis.

<span class="mw-page-title-main">Lacrimal groove</span> Sulcus in the jaw that leads to the sinus opening

On the nasal surface of the body of the maxilla, in front of the opening of the sinus is a deep groove, the lacrimal groove, which is converted into the nasolacrimal canal, by the lacrimal bone and inferior nasal concha; this canal opens into the inferior meatus of the nose and transmits the nasolacrimal duct.

<span class="mw-page-title-main">Lacrimal punctum</span> Part of human eye anatomy

The lacrimal punctum or lacrimal point is a minute opening on the summits of the lacrimal papillae, seen on the margins of the eyelids at the lateral extremity of the lacrimal lake. There are two lacrimal puncta in the medial (inside) portion of each eyelid. Normally, the puncta dip into the lacrimal lake.

Oculoplastics, or oculoplastic surgery, includes a wide variety of surgical procedures that deal with the orbit, eyelids, tear ducts, and the face. It also deals with the reconstruction of the eye and associated structures.

<span class="mw-page-title-main">Dacryocystorhinostomy</span>

Dacryocystorhinostomy (DCR) is a surgical procedure to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function.

<span class="mw-page-title-main">Dacryocystitis</span> Medical condition

Dacryocystitis is an infection of the lacrimal sac, secondary to obstruction of the nasolacrimal duct at the junction of lacrimal sac. The term derives from the Greek dákryon (tear), cysta (sac), and -itis (inflammation). It causes pain, redness, and swelling over the inner aspect of the lower eyelid and epiphora. When nasolacrimal duct obstruction is secondary to a congenital barrier it is referred to as dacryocystocele. It is most commonly caused by Staphylococcus aureus and Streptococcus pneumoniae. The most common complication is corneal ulceration, frequently in association with S. pneumoniae. The mainstays of treatment are oral antibiotics, warm compresses, and relief of nasolacrimal duct obstruction by dacryocystorhinostomy.

<span class="mw-page-title-main">Epiphora (medicine)</span> Medical condition

Epiphora is an overflow of tears onto the face, other than caused by normal crying. It is a clinical sign or condition that constitutes insufficient tear film drainage from the eyes, in that tears will drain down the face rather than through the nasolacrimal system.

<span class="mw-page-title-main">Marsupialization</span> Surgical technique for cysts and abscesses

Marsupialization is the surgical technique of cutting a slit into an abscess or cyst and suturing the edges of the slit to form a continuous surface from the exterior surface to the interior surface of the cyst or abscess. Sutured in this fashion, the site remains open and can drain freely. This technique is used to treat a cyst or abscess when a single draining would not be effective and complete removal of the surrounding structure would not be desirable. The technique is often applied to Gartner's duct cysts, pancreatic cysts, pilonidal cysts, and Bartholin's cysts.

<span class="mw-page-title-main">Dacryocystocele</span> Medical condition

Dacryocystocele (Dacryocystitis) or timo cyst is a benign, bluish-gray mass in the inferomedial canthus that develops within a few days or weeks after birth. The uncommon condition forms as a result as a consequence of narrowing or obstruction of the nasolacrimal duct, usually during prenatal development. Nasolacrimal duct obstruction disrupts the lacrimal drainage system, eventually creating a swelling cyst in the lacrimal sac area by the nasal cavity. The location of the cyst can cause respiratory dysfunction, compromising the airway. The obstruction ultimately leads to epiphora, an abundance of tear production.

<span class="mw-page-title-main">Accessory visual structures</span> External parts of the eye including eyebrow, eyelid, and lacrimal apparatus

The accessory visual structures are the protecting and supporting structures (adnexa) of the eye, including the eyebrow, eyelids, and lacrimal apparatus. The eyebrows, eyelids, eyelashes, lacrimal gland and drainage apparatus all play a crucial role with regards to globe protection, lubrication, and minimizing the risk of ocular infection. The adnexal structures also help to keep the cornea moist and clean.

<span class="mw-page-title-main">Nasolacrimal duct obstruction</span> Medical condition

Nasolacrimal duct obstruction is the obstruction of the nasolacrimal duct and may be either congenital or acquired. Obstruction of the nasolacrimal duct leads to the excess overflow of tears called epiphora.

<span class="mw-page-title-main">Nasal meatus</span> Nasal passage of the nasal cavity

In anatomy, the term nasal meatus can refer to any of the three meatuses (passages) through the skull's nasal cavity: the superior meatus, middle meatus, and inferior meatus.

<span class="mw-page-title-main">Dacryoscintigraphy</span>

Dacryoscintigraphy (DSG), also known as lacrimal scintigraphy, is a nuclear medicine technique for imaging the lacrimal apparatus. It is used to identify obstructions, for example in the lacrimal duct, nasal cavity or nasolacrimal duct.

References

  1. "Nasolacrimal System Anatomy: Embryology, Puncta, Canaliculi". 2020-02-19.{{cite journal}}: Cite journal requires |journal= (help)
  2. Herbert, Ronald A.; Janardhan, Kyathanahalli S.; Pandiri, Arun R.; Cesta, Mark F.; Miller, Rodney A. (2018). "Nose, Larynx, and Trachea". Boorman's Pathology of the Rat. Elsevier. pp. 391–435. doi:10.1016/b978-0-12-391448-4.00022-8. ISBN   978-0-12-391448-4. S2CID   80517730. The paired nasolacrimal ducts carry lacrimal secretions from the eye to the nasal cavity, and originate as oval openings near the edge of the medial canthus of the eyelids. Initially the duct is small and circular, but in the middle portion, the diameter increases and the appearance is more oblong and saccular. The diameter again decreases before the duct enters the ventrolateral nasal vestibule medial to the root of the incisor tooth approximately 2 mm caudal to the nares.
  3. "Medical Definition of PLICA LACRIMALIS". Merriam-Webster Medical Dictionary. 2020-05-08. Retrieved 2020-05-08. an imperfect valve at the opening of the nasolacrimal duct into the inferior meatus of the nose
  4. CARREIRO, J (2009). "Head and neck". Pediatric Manual Medicine . Elsevier. pp.  13–97. doi:10.1016/b978-0-443-10308-7.00002-8. ISBN   978-0-443-10308-7. Dacryostenosis is a condition whereby the nasolacrimal duct is narrowed or blocked and the glandular secretions into the eye are prevented from draining properly. The secretions collect around the orifice of the duct and in the corner of the eye, where they thicken, resulting in a gooey, sticky substance that further clogs any drainage route.
  5. Stagner, Anna M.; Jakobiec, Frederick A.; Eagle, Ralph C.; Charles, Norman C. (2018). "Infections of the Eye and Its Adnexa". Diagnostic Pathology of Infectious Disease. Elsevier. pp. 648–685. doi:10.1016/b978-0-323-44585-6.00021-7. ISBN   978-0-323-44585-6. Dacryocystitis is produced by obstruction of the nasolacrimal duct with resultant tear stasis. Clinically, patients display erythema and swelling of the lacrimal sac, creating a mass in the medial canthal area, centered below the medial canthal tendon.
  6. "Blocked tear ducts in infants" Archived 2012-07-08 at the Wayback Machine , Pediatric Views, June 2006.
  7. Nerad, Jeffrey A.; Carter, Keith D.; Alford, Mark (2008). "Disorders of the Lacrimal System: Congenital Obstruction". Oculoplastic and Reconstructive Surgery . Elsevier. pp.  131–137. doi:10.1016/b978-0-323-05386-0.50010-7. ISBN   978-0-323-05386-0.
  8. "Tears of Men and Women Are Different", Wall Street Journal , mirrored at "Why Men and Women Shed Different Tears", Fox News, May 5, 2011.