Rhinoplasty is one of the most common cosmetic procedures in Iran. There are many known adverse effects after this surgical procedure. One of the most common complications following rhinoplasty is temporary nasolacrimal duct obstruction due to surgical manipulation and soft tissue edema. Permanent nasolacrimal duct obstruction following rhinoplasty is less identified and should be considered in patient with persistent epiphora after this surgery.

10 patients with persistent epiphora after rhinoplasty during 6 years were collected. Dye disappearing test, canalicular probing and irrigation were performed for all of these patients. Orbital and paranasal sinuses CT scan without contrast was performed for all of the patients to search for nasolacrimal duct abnormalities.

All of the patients showed abnormal dye disappearing test. Canalicular probing showed hard stop sensation in 9 patients and soft stop sensation in one patient. Irrigation testing showed pus reflux in 4 patients, clear fluid reflux in 3 patients and free passage without reflux in 3 patients. Orbital and paranasal sinuses CT scan showed bone fracture in the lacrimal sac region in two patients, osteoma of the ethmoid bone in one patient and enlarged inferior turbinate in one patient.

Persistent nasolacrimal duct obstruction is one of the important complications of rhinoplasty that is overlooked. it’s important to search for anatomical integrity of nasolacrimal duct in patients with persistent epiphora after rhinoplasty. The location and extent of nasolacrimal duct injury following rhinoplasty could affect the prognosis after surgical correction of nasolacrimal duct obstruction.