Haemolacria a rare complication of Lefort I surgery

A rare complication of hemolacria after Le fort I osteotomy: a case presentation

Background

Nasolacrimal duct obstruction (NDO) is a common pathology preventing the proper drainage of the tears, and its main symptom is epiphora. Secondary acquired nasolacrimal duct obstruction (SANDO) can be due to a variety of causes including infection, trauma, or neoplasms. It has been reported to occur with different forms of maxillofacial trauma, especially Le Fort II, Le Fort III, naso-orbital-ethmoidal, and orbital floor fractures.

Case presentation

A 20-year-old Egyptian female presented to correct a facial disharmony due to a cleft lip and palate defect. The patient reported a history of congenital NDO and had deficient lateral nasal walls. Bimaxillary surgery was planned, including a Le Fort I osteotomy for the maxilla and bilateral sagittal split osteotomy for the mandible. The surgery was uneventful, but the patient complained from bloody tears or hemolacria few days postoperatively. This complication began to cease spontaneously after 2 days and completely recovered after 4 days.

Conclusion

Hemolacria is an infrequent finding after maxillofacial surgeries and may be associated with CLP surgeries more than other surgeries. In this case, it was easily managed, and surgeons should be more aware of it to try to prevent its occurrence.

Tears of blood - a female adolescent with essential idiopathic bilateral haemolacria: case report and brief review

Haemolacria is a rare condition that usually occurs secondary to a hidden pathology. On rare occasions when no underlying cause may be found, it is called essential idiopathic haemolacria. Here the authors report a case of a 13-year-old girl presented to the ophthalmology emergency department with spontaneous bloody tears from both eyes for the past six months. There was associated bleeding from the ear. The rest of the systemic and ophthalmology examinations were within normal limits. She was investigated systemically to look for any underlying pathology; however, her blood investigations, radiological imaging and local examinations performed by the Otorhinolaryngology, Ophthalmology, Gynaecology and Internal Medicine departments were all normal. A final diagnosis of bilateral essential haemolacria was made.