Endoscopic Dacryocystorhinostomy in a Patient With Hemi-Arrhinia

Congenital arrhinia and hemi-arrhinia can present with varying degrees of nasal hypoplasia. There are significant anatomical consequences to the lacrimal system, and treatment of epiphora in these cases is challenging, with few reports of successful external dacryocystorhinostomy or combined endoscopic and external dacryocystorhinostomy. A 12-year-old girl with left hemi-arrhinia presented with left-sided epiphora and chronic dacryocystitis due to an incompletely formed nasolacrimal system. She underwent a left endoscopic dacryocystorhinostomy via a right-sided transnasal approach in conjunction with otorhinolaryngology, with complete resolution of symptoms postoperatively. This is the first reported case in the literature demonstrating that epiphora in the setting of hemi-arrhinia may be successfully treated in a completely endoscopic fashion with a multidisciplinary team and stereotactic navigation.