Purpose: This study describes lacrimal tract involvement and surgical outco
me in patients with mucocutaneous leishmaniasis.
Methods: Four patients, ages 20 to 75 years, had nasal lesions resulting fr
om mucocutaneous leishmaniasis and sought treatment for chronic dacryocysti
tis. Each patient had had lacrimal symptoms since childhood or early adulth
ood, concomitantly with the development of upper airway lesions. Dacryocyst
ography showed nasolacrimal duct stenosis in all cases on the affected side
. Three patients underwent dacryocystorhinostomy (one bilaterally), and one
patient had bilateral dacryocystectomy.
Results: Two patients had surgical fistula closure soon after surgery. A se
quential endoscopic operation for remotion of a synechia between the fistul
a and the middle turbinate was successful in one of these patients. Histopa
thologic analysis of lacrimal sacs and nasal mucous membranes close to the
anastomotic site revealed chronic nonspecific inflammatory process and nega
tive immunohistochemistry for Leishmania.
Conclusions: Dacryocystitis may result from nasal mucocutaneous leishmanias
is. The surgical outcome was unsatisfactory in one of the four patients.