Title : Relationship between tear meniscus parameters and nasal anatomy: Does nasal septum deviation affect tear parameters?
Abstract:
Purpose: To investigate whether nasal anatomical alterations associated with nasal septum deviation (NSD) contribute to early functional impairment in the lacrimal drainage system, potentially indicating subclinical stages of primary acquired nasolacrimal duct obstruction (PANDO).
Methods: Sixty-nine patients with unilateral NSD were included. Individuals with clinical or radiological evidence of PANDO were excluded. Lower tear meniscus height (LTMH) and area (LTMA) were bilaterally measured using anterior segment optical coherence tomography (AS-OCT). Nasal anatomical parameters were assessed on both the deviation side (DS) and contralateral side (CS) using paranasal sinus computed tomography (PNS-CT).
Results: Of the patients included in the study, 34 (49.28%) were female and 35 (50.72%) were male, with a mean age of 32.19?±?11.89 years (range: 18–59). The LTMH and LTMA values were significantly higher on the deviation side (DS) compared to the contralateral side (CS) (p?<?0.0001 for both). On the DS, LTMH demonstrated significant positive correlations with concha nasalis inferior-bone thickness (CNI-BT), attachment angle, the angle between the CNI and the medial wall of the maxillary sinus (CNI-MS angle), CNI length, and inferior nasal meatus volume (INMV) (p?=?0.014, p?<?0.0001, p?<?0.001, p?=?0.018, and p?=?0.002, respectively). Similarly, LTMA on the DS was significantly positively correlated with CNI-BT, attachment angle, CNI-MS angle, CNI height, CNI length, INMV, and nasal cavity volume (NCV) (p?=?0.027, p?=?0.008, p?=?0.004, p?=?0.048, p?=?0.036, p?=?0.024, and p?=?0.029, respectively). No significant correlations were identified between TMPs and nasal parameters on the CS.
Conclusion: NSD may impair tear drainage even in the absence of clinical signs of PANDO. The observed correlations between TMPs and specific nasal anatomical structures suggest that sinonasal alterations secondary to NSD may contribute to subclinical tear stasis. These findings highlight the potential role of nasal anatomy as an early indicator of predisposition to nasolacrimal duct obstruction in asymptomatic individuals.
Keywords: Tear meniscus parameters, lacrimal drainage system, nasal septum deviation, concha nasalis inferior
