Cone-beam computerized tomography use for determination of optimal treatment tactics in patients with tear drainage system pathology conditions

At present time, many methods to diagnose pathological conditions of the lacrimal drainage system are known. An improvement of radiological methods is necessary for the choice of optimal treatment tactics in patients of this category. Authors propose their radiological method for tear drainage impairment diagnosis - a cone-beam computerized tomography (CBCT) of paranasal sinuses with simultaneous contrast examination of lacrimal pathways. Data analysis algorithm is worked out. Results of lacrimal pathways status estimation based on CBCT with contrast test in 53 patients allowed determining the lacrimal pathways stenosis levels, structural aspects of the lacrimal sac walls, nasolacrimal channel, as well as the impact of anatomical structural features of the nasal cavity and paranasal sinuses on the development of the individual pathological condition of the lacrimal pathways. This determined the following optimal treatment tactics. Conclusion: this method is highly informative, cost-effective with low radiation exposure and possibility to perform serial follow-up examinations in patients with lacrimal pathways pathological conditions. Therefore, this could help a clinician in correct diagnosis and in determination of optimal treatment tactics.

cone-beam computerized tomography (CBCT), contrast, lacrimal pathways, paranasal sinuses, dacryocystitis, laser-assisted dacryocystorhinostomy