To report a rare case of osteoma causing epiphora 8 years after dacryocystorhinostomy.

Osteoma develops commonly in paranasal sinuses. It is usually asymptomatic, and presenting symptoms are almost always consequences of mass effect and compression on adjacent tissues. The authors describe the case of a 32-year-old man who presented with epiphora, 10 and 8 years after rhinoplasty and dacryocystorhinostomy, respectively. Complete reflux was seen with irrigation test, and orbital Ct-scan showed a large bony mass in ethmoidal sinus and nasal cavity that was extended to frontal sinus.

On histopathological examination, osteoma was reported. Symptoms and signs were improved after debulking of the mass.

Although, this tumor is more likely a missed diagnosis at the time of previous surgery, but secondary mass formation following dacryocystorhinostomy could not be ruled out. Ophthalmologists and orbital surgeons should have in mind that nasolacrimal duct obstruction, especially in young patients, may be caused by a secondary etiology. Therefore, complete investigation to rule out these etiologies should be done prior to surgery.