Recurrent bilateral dacryocystoceles in Wegener's granulomatosis: a rhinologic perspective

Westbrook, Benjamin James; Scurry, W. Cooper; Hudak, Donald T.; McGinn, Jonathon; Stack, Brendan C.

doi:10.1016/j.amjoto.2006.01.005

« Previous Next »American Journal of Otolaryngology - Head and Neck Medicine and Surgery
Volume 27, Issue 6 , Pages 409-412, November 2006

Recurrent bilateral dacryocystoceles in Wegener's granulomatosis: a rhinologic perspective

Benjamin James Westbrook
- Hébert School of Medicine, Uniformed Services University of the Health Sciences, Bethesda, MD, USA
W. Cooper Scurry Jr, MD
- Division of Otolaryngology, Department of Surgery, Head and Neck Surgery, Penn State University College of Medicine, Hershey, PA, USA
Donald T. Hudak, MD
- Department of Ophthalmology, Penn State University College of Medicine, Hershey, PA, USA
Jonathon McGinn, MD
- Division of Otolaryngology, Department of Surgery, Head and Neck Surgery, Penn State University College of Medicine, Hershey, PA, USA
Brendan C. Stack Jr, MD, FACS
- Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, Little Rock, AR, USA
- Corresponding author. Department of Otolaryngology-Head and Neck Surgery, University of Arkansas for Medical Sciences, 4301 West Markham, Slot 543, Little Rock, AR 72205, USA. Tel.: +1 501 603 1212; fax: +1 501 686 8029.

Received 16 December 2005

Abstract

Wegener's granulomatosis (WG) is a rare, idiopathic, systemic vasculitis of small vessels that manifests in multiple organ systems. Otorhinolaryngic manifestations of this disease include recurrent sinusitis and relapsing polychondritis. Periocular involvement is also a well-documented location of Wegener's disease. We present the case of a 13-year-old girl with severe WG who developed multiple recurrent orbital infections. She underwent multiple incision and drainage surgeries of each orbit and multiple courses of intravenous antibiotics. The patient persistently reaccumulated purulence in her nasolacrimal duct system and was referred to an oculoplastic surgeon for evaluation of these recurrent infections. The diagnosis of dacryocystitis as a complication of WG was made. This unique case represents a patient with severe WG developing bilateral dacryocystitis requiring bilateral dacryocystorhinostomies.