Endoscopic and dacryoendoscopic visualization of two individual canalicular openings into the lacrimal sac with a missing common canaliculus

Individual canaliculi entering the lateral wall of the lacrimal sac without forming a common canaliculus are unusual. It has been documented in radiological studies in 2% of cases.[1] There have been recent reports on endoscopic visualization of these individual canaliculi with an absent common canaliculus.[1,2] This case describes endoscopic and dacryoendoscopic features of two discrete canaliculi with an absent common canaliculus in a 27-year-old boy. He underwent a left endoscopic dacryocystorhinostomy. On marsupialization of the lacrimal sac, there were two individual openings seen on the lateral wall of the lacrimal sac [black arrows, Fig. 1 a-d] separated by a common wall [yellow arrow, Fig. 1a-d]. The lower opening looked wider in a close-up view [black circle, Fig. 1d].Figure 1: (a-d) Two discrete canalicular openings into the lacrimal sac without a common canaliculusDacryoendoscopic examination of both individual canaliculi revealed a narrow upper canaliculus [Fig. 2a-c] and a wider lower canaliculus with prominent folds [Fig. 2d-f].Figure 2: Dacryoendoscopic visualization of upper (a-c) and lower canaliculus (d-f)This is the first case describing dacryoendoscopic features of discrete upper and lower canaliculi in a case with absent common canaliculi. Informed consent Informed consent was obtained from the patient for publishing the photographs along with all the relevant data. Financial support and sponsorship Nil. Conflicts of interest There are no conflicts of interest.