Early trends of secondary acquired nasolacrimal duct obstruction in COVID-19 associated sino-orbital mucormycosis: SALDO update study (SUP) – Paper IV.

Publication date: Jun 01, 2024

To study the emerging trend of development of secondary acquired nasolacrimal duct obstruction (SALDO) in the cases treated for rhino-orbito-cerebral mucormycosis (ROCM). Prospective, interventional case series of five patients who developed SALDO post-surgical and medical management of ROCM. The mean age was 45. 4 years (range: 40-62 years), all five being males. Right lacrimal drainage pathways was involved slightly more than the left (right:left = 3:2). Epiphora and discharge were the main presenting features. All five patients were treated with extensive debridement of the nose, sinuses, orbit and cerebral involvement as needed followed by medical management for ROCM. CT- Dacryocystography for all 5 patients showed obstruction at the lower end of the nasolacrimal duct. The patients underwent external dacryocystorhinostomy with mitomycin-C with or without intubation with good anatomical and functional outcomes at 6 months follow-up. The present series highlights the possible etiology of development of SALDO in cases treated for ROCM, its management and discusses the role of Computed Tomography Dacryocystography (CT-DCG) in understanding the pathophysiology of the development of SALDO along with delineating the spatial relationship of the lacrimal drainage system with the surrounding structures.

Concepts Keywords
Dacryocystorhinostomy Lacrimal
Males Rhino-orbito-cerebral mucormycosis
Months ROCM


Type Source Name
disease MESH nasolacrimal duct obstruction
disease MESH COVID-19
disease MESH mucormycosis
disease MESH Epiphora
disease VO nose
drug DRUGBANK Mitomycin
disease MESH etiology

Original Article

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