Paper - The genesis and development of the nasolacrimal passages in man
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Schaeffer JP. The genesis and development of the nasolacrimal passages in man. (1912) Amer. J Anat. 13(1): 1-18.
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The Genesis and Development of the Nasolacrimal Passages in Man
J. Parsons Schaeffer
From the Anatomical Laboratories of Cornell and Yale
A brief review of the literature on the nasolacrimal passages [laerimal duets (lachrymal canaliculi), lacrimal sac, nasolacrimal duct] shows that diverse views were from time to time advanced on the genesis and development of these passages Before considering the material studied in this investigation I Want to refer to some of the theories held by earlier Writers. I do not wish to give a complete resume on the history of the development, but rather in a brief manner indicate the evolution in our knowledge concerning the genesis and development of these passages.
v. Baer (’28~’37) thought that the nasolacrimal passages had their origin in a diverticulum from the ‘ Rachenhohle.’ His theoryl presumably was based upon hypothetical conclusions, since it is entirely unsupported.
Burdach (’37) in his ‘Die Physiologie als Erfahrungswissenschaft’ Writes brieﬂy concerning the genesis of the nasolacrimal
1 Die Bildung des Thrzmenkanals (in birds) glaubte ich in einerA11ssti'1lpung der Rachenhohle, die zuerst nur wenig vor der Eustachischen Rohre liegt und sehr bald nach dieser sichtbar wird, zu erkennen, doch habc ich bisher noch nicht den gesammten Vorgang verfolgt. Uber Entwiclcolungsgeschichte der Thiere, Thiel 2, s. 116. '
Der Thranengang stillpt sich auch hier (in mammals) aus der Rachenhijhle gegen das Ange hervor und liegt Anfangs hintcr den Muscheln,~die nur, indem sie sich verlangern, sich iiber ihn ziehen. Uber‘Entwickelungsgeschichte der Thiere, Thiel 2, S. 219.
passages, but does not state his meaning clearly? He apparently thought that the nasolaerimal passages had their origin in a diverticulum or skin-fold (‘Hautfalte’) in the region of the medial palpebral commissure (internal canthus) and, since the nascoptic‘ ﬁssure is obliterated by the eighth week of embryonal life, he must have thought that the ‘Hautfaltc’ grew into the substance of the maxilla, ultimately reaching the nasal cavity. Burdach may have had the right conception of the development of the nasal end of the naselaerimal duct, but in the genesis of the nasolacrimal passages from a skin-fold (‘Hautfalte’) in the region of the medial palpebral commissure he erred (providing the writer interprets his statement correctly). It is difficult to say what Burdach meant by his ‘Hautfalte.’ That the anlage of these passages comes to lie in the body of the maxilla is true, but it comes about in an entirely different Way as Will be seen subsequently. His theory would not explain the origin of the paired lacrimal ducts.
Erdl (’45) and Coste (’47—’59), according to Ewetzky, believed that the furrow “Welche am Naseneingange beginnt und am inneren Augenwinkel miindet, auf ihrer ganzen Lange fiberbriickt und dergestalt in einem Canal verwandelt.” That the naso-optic ﬁssure becomes constricted or shut off from the surface by its lips closing in and coalescing with each other, thus establishing the nasolacrimal connections, was indeed the accepted theory for some time. The theory is, of course, erroneous because the anlage of the passages is for some time represented by a solid plug or strand of epithelial cells which earlybecomes detached from the surface. The strand of cells becomes cord-like and acquires a lumen secondarily (see subsequent paragraphs). Neither would this theory explain the pairing of the lacrimal duets.
So far as my review of the literature would prove, Born (’76) Was the ﬁrst investigator to properly interpret the earliest stages of the nasolacrimal passages. He investigated this ﬁeld in amphibia and found a structure homologous with that described by Coste for mammals, but he found that its genesis did not agree with Coste’s hypothesis.
2 Der innere Augenwinkel ist mehr verlangert als bei Erwachsenen und steht tiefcr als der aussere; schon in der achten Woe-he erscheint in ihm die Karunkel und eine zur Mudnasenhohle sich sekende I-lautfalte als Anfang des Thranenkanals. Die Thriinenpunlste ragen im fiinften Monat sehr stark l1BI'VOI‘ und im siebenten etwas mehr zuriick.
Since Born’s conception of the genesis of the nasolacrimal passages in amphibia applies also, broadly speaking, in other forms, it may not be amiss to brieﬂy quote his own words:
- "Der Thranencanal der Amphibien bildet sich durch Einwachsung und Absehniiriing eines Epithelstreifens von der Nase bis zum Auge hin der dann ein Lumen bekonunt und sich mit der Nascnholile in Verbindung setzt."
While the above did not clear up the origin of the lacrimal ducts in mammals, it nevertheless proved to be the correct interpretation of the genesis of the main portion of the nasolacrimal duct in all investigated forms up to the present. According to Born, in amphibia, a solid strand of epithelial cells, extending from the eye to the nose, becomes detached from the surface epithelium and this strand of cells later acquires a lumen. The strand of cells retains connections with the surface epithelium at both the ocular and nasal ends. This strand of cells becomes both the lacrimal ducts and the Whole of the nasolacrimal duct.
Born later (’78) investigated lizards and birds and found that the basic principles concerning the anlage of the nasolacrimal passages in these forms agreed with What he found in amphibia. He, however, found that the cord of cells differentiated along the course of the oculo-nasal furrow; also that it differed somewhat in its further development. In both forms (lizards and birds) a solid cord of cells became isolated from the surface. In lizards the isolation was complete, i.e., there remained no connection with the surface epithelium at any point; both lacrimal ducts and the nasal end of the nasolacrimal duct developed as sprouts from the mother cord of cells. As in amphibia the lumina of these several channels Were. established later. In birds the cord of_ cells retained connection with the surface epithelium at both the ocular and nasal ends. One of the lacrimal ducts, however, developed as a sprout from the ocular end of the mother cord of cells.
Ewetzky (’7 9) studied the embryology of the nasolacrimal connections in ‘Rindscmbryonen’ and in the main agreed with B0rn’s ﬁndings.
Born (’82) investigated reptiles and found that the solid cord or strand of epithelial cells retained connection with the surface epithelium at the ocular end, but that the nasal end of the nasclacrimal duct grew a sprout from the mother cord of cells. He also found that there is no doubling or pairing at the ocular end; that is, he found but one lacrimal duct.
Legal (’83) investigated the pig and came to the same general conclusion as did Born, and claimed (for pig) that the superior lacrimal duct was Wholly a part of the original mother cord of cells. He further claimed that the mother cord of cells retained superiorly and dorsally a connection with the epidermis in the region of the palpebral ﬁssure.3 He concluded that the inferiorlacrimal duct grew as a sprout from the mother cord, but he found that the sprout did not reach the free border of the inferior eyelid; therefore remaining ‘funktionell unbrauchbarfi
ing to Fleisher, depending upon the form studied, came to the conclusion that one of the two lacrimal ducts was wholly or partly a portion of the original mother cord of cells, and that the other lacrimal duct and the remaining portion of the nasolacrimal duet developed as sprouts from the mother cord.
Kolliker C84) believed that both lacrimal ducts developed as sprouts from the mother cord.
Ewetzky (’88) thought that the ocular end of the mother cord divided into two forks, and that these forks in turn developed into the lacrimal ducts (superior and inferior).
J ouves (’97) studied the sheep and man, and found in a 19 mm. human embryo both lacrimal ducts present but without any connection with the surface epithelium at this time.
Cosmettatos (’98) investigated the rabbit, and Staneuleanu (’00) the bird, the sheep, and man. These investigators, accord 3 . . . . ganz hinten cndlich bleibt bestandig cine Verbindung mit der Lidfurche erhalten.
4 Bei Schweinscmbryonen ist die Tl1ranenl<analanlage eine solide, Von der tiefen Epidermisschicht des Thrancnfurchengrundes ins Bindegewebe einwucl1crnde Leiste, die sich bis auf das hinterste Ende am innern Augenwinkel von der Epidermis absehniirt, und mit dem vordern, stark auswachsendcn Ende mit der Nasenhohle verbindct: der abgeloste, solide Epithelstrang stellt den spatern einfachen Thranennasengang und das obere Thranenrijrchen dar, das untere sprosst aus demselben hcrvor, bleibt aber, da cs die freie liidﬂtiche nicht erreicht, funktionell unbrauehbar.
Hammar (’02) shows a model5 of a human embryo 18.5 mm. long in which both the nasal and ocular ends of the anlage of the nasolacrimal passages are free from the surface epithelium. The anlages of the laerimal ducts are well illustrated in the model.
Fleisher (’06) published his researches on the pig, the guinea pig, the mouse, the rabbit, and man. He arrived at the following general conclusion:
Aus diesen Praparaten geht hervor, (lass beim Menschen die Entwieklung der Tranenrohrchen in derselben Weise vor sich geht, wie bei den anderen, von mir untersuehten Saugetiercn, durch selbstandige Sprossung jedes der Rorchen aus dem Augencnde der Triinenleiste, die sieh vollstandig voin Epithel abschniirt.
Fleisher, therefore, disagrees with Legal and some others on the genesis of the lacrimal duets (lachrymal canaliculi), and conforms with Kolliker and more nearly to Ewetzky. He is also in accord with Matys who came to similar conclusions for Spermophillus citillus.
Lang (’11) reports his findings in a human embryo, aged from seven to eight weeks. He ﬁnds that the left side of his embryo agrees with the conclusions of Fleisher and Matys. On the right side he, however, finds the superior lacrimal—duct anlage wanting.
In subsequent portions of this paper I wish to record my preliminary observations on the genesis and development of the nasolacrimal passages in man. I now hope to carry this study farther and, if an investigation of a larger number of human embryos warrants, will report my later observations and conclusions in a subsequent paper.
In looking over material for the substance of another paper I noticed variations in the development of some portions of the nasolacrimal passages. I, therefore, felt that there was need of an investigation of the genesis of these passages in man, based upon an examination of a larger number of human embryos than was formerly done. Fortunately there were available for this study good series of appropriately aged embryos showing the genesis and early stages of the nasolacrimal passages. The embryos ranged in age from thirty days to ‘term.’ A certain amount of material of the early extra-uterine period was also studied; ‘together with a large number of adult specimens.
5 Studien fiber die Entwicklung des Vorderd-arms und einiger angrenzenclen Organe, Archiv f. mikrosk. A11at., Bd. 59, taf. 26, ﬁg. 14.
It is well known that at one stage of the embryo there is a furrow or ﬁssurc—the naso—optic ﬁssure—extending from the eye to the nasal pit. This ﬁssure is bounded superiorly by the lateral nasal process and inferiorly by the maxillary process. The nasooptic ﬁssure gradually disappears by a growth and coalescence of the structures bordering it. Inthis manner the ﬁssure is ‘out—folded’ as it were and thus becomes shallower and shallower until its ultimate obliteration. The epidermis along the course of the ﬂoor of the now very rudimentary ﬁssure concerns us for some time longer with reference to the anlage of the nasolacrimal passages.
Before the naso—optic ﬁssure is entirely obliterated We have in frontal sections a thickening of the deeper layers of the epidermis along the ﬂoor of the very rudimentary ﬁssure (ﬁg. 2). This initial thickening is the anlage of the nasolacrimal passages. It is at first, and remains so for some time, a solid cord—like structure of epidermal cells, at all points a part of the epidermis, along the ﬂoor of the remains of the naso—optic furrow, extending from the neighborhood of the eye towards the nose.
My observations began on embryos aged approximately from thirty to thirty—two days. In these embryos I could ﬁnd no evidence whatever of an anlage of the nasolacrimal passages. ‘In ﬁg. 1 we have a frontal section through the remains of the naso—optic ﬁssure (human embryo aged approximately thirtythree days). Note that there is no evidence of the anlage of the nasolacrimal passages along the ﬂoor of the rudimenatry ﬁssure. The epidermis appears uniform in thickness at all points, i.e., the epidermis is not thickened along the ﬂoor of the ﬁssure.
Fig. 1 Frontal section through the nasal fossa (f) and the now-rudimentary naso-optic furrow (-no), from a human embryo aged approximately thirty-three days. Note that there is no evidence of thickening of the epidermis along the floor of the rudimentary naso-optic furrow (no), to establish the anlage of the nasolacriinal passages. X 62.4
Fig. 2 A similar section to that illustrated in ﬁg. 1, from a human embryo aged thirty-four days. Note the plug—like thickening of the epidermis in the position of the rudimentary naso—optic furrow. This is the first evidence of the anlage of the nasolaerimal passages. X 62.4.
Fig.3 A corresponding section to those illustrated in ﬁgs. 1 and 2, from a human embryo aged approximately thirty—ﬁve days. Note the marked in-growth of the epidermal plug in comparison to the plug represented in ﬁg. 2. X 62.4.
Fig. 4 A frontal section through the anlage of the nasolacrimal passages, from a human embryo aged forty-three days. Note that the cord of epidermal cells is now entirely separated from the surface. It is wholly surrounded by mesenchymal cells. In the sections preceding and following this the separation from the surface was just as complete as in that shown here. X 62.4.
The ﬁrst evidences of the anlage of these passages I found in a 12 mm. embryo, aged about thirty-four days. The anlage is well illustrated in ﬁgs. 2 and 7 as a plug—like thickening (in frontal section) of the deeper layers of the epidermis along the floor of the remains of the naso—optie ﬁssure. Note especially that the surface layer of ﬂat epidermal cells is not included in the anlage of the nasolacrimal passages. In this respect I am in accord with Born, Legal and others and at variance with Evvetzky’s first paper (’79). As to age for the ﬁrst evidences of the anlage of the nasolacrimal passages I agree rather closely with Ewetzky, who found that “die Entwickelung des Thraneneanals beginnt um das Ende der 5. oder im Anfang; der 6. Woche des F otallebens.” The anlage of the nasolaerimal passages soon becomes sufficiently developed to sink into the cerium along the course of the rudimentary naso—optie ﬁssure. The anlage grows rapidly and in a brief time it has grown to such an extent that it reaches into the underlying mesenehyrnal tissue. VVitness for example ﬁgs. 3 and 8, which represent frontal sections through theileft nasal fossa of an embryo aged approximately thirty-ﬁve days. In these ﬁgures the ridge of epithelial cells has grown into the underlying mesenchyrnal tissue. Note especially, however, that the anlage still retains its connection with the rete mucosum of the epidermis along the course of the naso-optic groove, in which it has its genesis. Note further that the anlage is as yet solid and that there is no evidence of lumen formation.
Fig. 5 Selected sections from a series through the developing nasolacrimal passages (human embryo aged from forty-three to forty-live days). Note that nowhere are the anlages of the nasolaerimal passages in connection with the surface. The laerimal ducts are already in evidence. All of the ‘passages’ are yet solid cords of epithelial cells, and are indicated in deep black. X 14.
Fig. 9 represents a semi-frontal section through a later stage of the anlage (embryo aged about forty-three days). Note that now the cord of epithelial cells is entirely detached from the surface, i.e., it h.as entirely lost its connection with the rete mucosum of the epidermis from which it arose. The anlage of the nasclacrimal passages now lies well embedded in the mesenchymal tissue. It will be further noticed that the central cells of the cord-like anlage (ﬁg. 9) have taken the stain less deeply, and apparently there is already an attempt at lumen formation. Some of the central cells seem to be in a state of ‘neerobiosis.’ The cells of the cord are apparently becoming re-arranged to form a wall in anticipation of a later lumen.
In the serial frontal sections through the nasal cavity of a forty-three day embryo represented in ﬁgs. 10 and 11, the complete isolation from the surface of the nasolacrimal passages at this stage of development is well illustrated. The embryo from which these photomicrographs were made is in a splendid state of preservation. It is human embryo no. 3 (Hess Embryo) of the Cornell University Series. It belongs to the research collection of Professor and Mrs. Gage.
This embryo shows several Very important points in connection with the development of the nasolacrimal passages: In the first place We ﬁnd at this stage that the anlages of the nasolacrimal passages are nowhere connected with the epidermis, but that they are entirely encompassed by mesenchyrnal tissue. In the second place it will be noticed that the cords of cells are solid, with here and there evidences of lumen formation. The series also shows some irregularities and lateral buds from the main cords. These may account for the very common diverticula of the adult nasolacrimal duets (ﬁg. 30). Finally the series shows that the lacrimal ducts (lachrymal canalieuli) begin as sprouts from the ocular end of the mother cord of cells. Both the superior and inferior lacrimalvducts are about equally advanced in development, but neither of them have progressed far enough to reach the free borders of the eyelids and thus establish the deﬁnitive connections between the anlages of the nasolacrimal passages and the epidermis.
Figs. (5, 7, 8 and 9 Photomierographs of frontal sections showing several stages in the development of the nasolacrimal passages; (1,, b, c = remains of the naso-optic furrow; f=nasal fossa; e=eye; d=diﬂ‘erent stages of the anlage of the nasolacrimal passages.
Fig. 6 Note that there is no evidence of the anlage of the nasolacriinal passages in the region of the naso-optic furrow (u.). Human embryo aged thirtythree days. X 68.
Fig. 7 Note the plug-like anlage of the uasolaerimal passages (d) from the deep layers of the epidermis along the ﬂoor of the naso-optic furrow (b). Human embryo aged from thirty-four to thirty-ﬁve days. X 68.
Fig. 8 In this section the anlage of the nasolacriinal passages is considerably advanced over that shown in ﬁg. 7. Note, however, notwithstanding that it has pushed its way into the underlying mesenchymal tissue, that the anlage still retains its connection with the deeper layers of the epidermis along the floor of the naso-optic furrow ((2). Human embryo aged about thirty—six days. X68.
Fig. 9 In this section the anlage of the nasolacrimal passages has lost its connection with the surface. Human embryo aged forty-three days. X 68.
Figs. 10 and 11 Photomicrographs of frontal sections in the region of the developing nasolaurimal passages, from a human embryo aged forty-three days. Note the anlages of the nasolacrimal passages and that they are entirely separated from the surface. The lacriinal-duct anlages are Well advanced and show as sprouts from the mother cord. The nasal..end of the cord has not developed sulﬁciently to come in Contact with the mucous membrane. of the inferior nasal rneutus. The lacrimal ducts are also some distance from the free borders of the eyelids at this time. The section represeutocl in ﬁg. 10 is the most ventral of the series and that represented in ﬁg. 11 the most dorsal. Some of the intervening sections of the series are. of course, omitted. Embryo no. 3-Hess, Cornell University Series. 1; = anlage of lmsolaerimal duct; 'L'nf= anlage of inferiorlztcrimalduct; sup = anlage of superior laerimal duct; e = eye. X ‘27. 12
The lacrimal ducts are also solid cords of cells and show no evidence of lumen formation. In this series (ﬁgs. 10 and 11) it would indeed be diﬂieult to sayiwhich of the lacrimal ducts (superior or inferior) was the ﬁrst to begin its budding from the mother cord. Presumably they started budding approximately at the same time.
So far as my observations would prove there is considerable variation in the development of the laerimal ducts, notwithstanding that both ducts begin, I believe, as buds from the mother cords of cells. The two ducts do not always begin their development at the same time. If they do begin at the same time then one or the other is often relatively tardy in its growth.
In ﬁgs. 12 and 13 are represented frontal sections through the nasal cavity of a forty—two to forty-ﬁve day embryo. On the left side of this embryo (ﬁgs. 12 and 13) the superior lacrimal duct is well advanced, almost reaching to the free border of the eyelid. The inferior lacrimal duct on the other hand is extremely backward in its development. The only structure present—a small lateral bud from the mother cord of cells, that may be the beginning of the inferior lacrimal duct, is shown in ﬁg. 12. I, however, am not at all sure that this is the anlage of the inferior duet. It is a well known fact that one or the other lacrimal-duct anlage may fail to reach the free border of the eyelid. It is, therefore, possible, had this embryo (ﬁgs. 12 and 13) continued its development to ‘term,’ that it would have been born without a drainage duct for the inferior eyelid. On the other hand, on the right side of the same embryo both lacrimal—duct anlages are equally developed.
To say, from the condition found in the embryo represented in ﬁgs. 12 and 13, that the superior laerimal—duet anlage is a portion of the original mother cord of cells is I believe erroneous. I rather hold, in such cases, that the infer-ior—duet anlage is tardy in its development, and that both duets have their anlages in buds from the mother cord. Of course as stated above one or the other duct may at times. for unknown reasons, fail to develop far enough to gain coalescence with the free border of the eyelid; or the duct may reach the border of the lid but-fail to establish a lumen at this point. Cases have also been reported in which supernumerary lacrimal puncta and lacrimal ducts were present (Weber and others). There are at times small buds arising, from the lacrimal-duct anlages, and in all probability these at times continue to develop independently until they reach and gain coalescence with the eyelids. The lumina for these super-numerary laerimal ducts are, of course, established just as they are in the regular ducts.
Figs. 12 and 13 Photomicrographs of frontal sections of a human embryo aged forty-two to forty-five days, in the region of the early lacrimal passages of the left side. Note that the superior laerimal duct (sld) is well advanced. The only evidence of an inferior duct is seen in ﬁg. 12, at point marked X. Whether this early condition would have led to an absence of the inferior lacrirnal duct is of course not known. slcl = superior lacriinalduct; as = anlage (17) of inferior lacrimal duet. X 32.
By the beginning of the third month (in some cases before) the lacrimal-duct cords have developed sufficiently to come in contact with the epithelium on the free borders of the eyelids. VVe will, however, ﬁnd that the ducts are as yet in places solid cords. Portions of the mother cord, especially the portion that is destined to become a portion of the lacrimal sac, are active in lumen formation at this time. The fundus of the lacrimal sac apparently develops as a sprout from the mother cord. The nasal end of the mother cord has not developed sufﬁciently to come in contact with the mucous membrane of the inferior nasal meatus. It is, however, not far removed, and in a laterstage embryo it will be found coalesced with the nasal mucous membrane. Lumen formation at the point of coalescence of the mother cord with the nasal mucous membrane is delayed approximately until ‘term’ (figs. 22, 23 and 24).
Frontal sections of embryos aged approximately one hundred days will show that the nasal end of the mother cord of cells has developed to the nasal mucous membrane and has coalesced with it. Both laerimal—duct cords have grown to the free borders of the eyelids and have coalesced with the epithelium at these points. The mother cord of cells, or the portion destined to become the greater portions of the laerimal sac and the nasolacrimal duct, has by this time established irregular lumina at various points. The latter are best developed at the ocular end of the primary cord and towards the nasal end of the Cord. The lacrimal—duct cords have also established lumina at various points, especially in the regions of the knees, or what will later become the ampullae of the laerimal ducts.
In ﬁgs. 14, 15 and 16 (embryo aged one hundred and seven days) is well illustrated the irregular manner in which the cords of epi Figs. 14, 15, and 16 Photomierographs of frontal sections through the nascIaerirnal passages of a human embryo aged one hundred and seven days. Note both laerimal ducts (fig. 14) in contact and fused with the epidermis in the region of the free borders of the eyelids. The laerimal ducts have not yet established lurnina in the regions of the eyelids (ﬁg. 14). The remaining portions of the ducts are more orless patent throughout. Note the irregularity of lumen formation in the nasolacrimal duet (fig. 16). std = superior laerimal duct; 1'ld= inferiorlaerimalduet; cld = common laerirnal duet; ls = laerimal sac; nld = nasolacrimal duct. X 10.5.
thelial cells establish lumina. Note that the lacrimal ducts are more or less patent throughout, save at the free borders of the eyelids where solid cords still persist. The horizontal and vertical portions of the lacrimal ducts are well shown (ﬁg. 14). The lacrimal sac (ﬁg. 15) is well advanced but the remainder of the nasolaerimal duct is not wholly patent. Even at this early stage there is some evidence of beginning diverticula from the .nasolacrimal duct (ﬁg. 16). The connection with the inferior nasal meatus is, of course, not yet established (ﬁg. 16).
According to my studies, the ocular end of the mother cord is the first to establish a lumen. The horizontal portions of the lacrimal ducts become patent before the vertical portions (ﬁgs. 14 and 17). The last parts of the vertical portions of the lacrimal ducts to become patent are the junction points between the laerimal-duct cords and the epithelium of the free borders of the eyelids (ﬁg. 17). The nasal end of the mother cord establishes a lumen before the middle portion of the cord (ﬁgs. 19 and 20). The middle portion remains solid, according to my series of embryos, for some time longer (ﬁg. 19). The last portion of the nasolacrimal passages to become patent is at the point of coalescence between the nasal sprout of the mother cord and the nasal mucous membrane. This is usually deferred, as stated before, until ‘term’ or even later (ﬁg. 24).
In the adult we ﬁnd varying positions on the lateral wall of the inferior nasal meatus for the ostium of the nasolacrimal duct. The ostium also varies as to shape, and it is occasionally duplicated. Rarely we ﬁnd a triplicity of the ostium.
The position of the ostium, i.e., whether at the highest point of the inferior nasal meatus, or at varying distances below the above point on the lateral nasal wall, depends, of course, largely upon the original point of coalescence of the mother cord of cells with the nasal mucous membrane (ﬁg. 28). At times the area of coalescence between the cord of cells and the nasal mucous membrane is rather extensive (ﬁg. 21). In such cases, due to the irregular mode of lumen formation, two or more ostia may readily b.e formed (instead of the usual single ostium) with a bridge of intervening tissue remaining permanently. The different shapes 49] "0
Figs. 17-21 Photomicrographs of frontal zseutions thmugh the nz-Lsn1acri1na.l passages of a human embryo aged one hundred and twenty days. Note the solid portions of the lat:rin1al ducts in ﬁg. 17. In ﬁg. 18 we mwo a patent section (ls) of the ocular end of the nasol-rm-,1'ima1 duct, and in ﬁg. 19 a section of the mid—portion of the nasolacrimal duct, still solid (nld). Note the well established lumen (nlrl) at the nasal end of the nasolacrimal duct in ﬁgs. 20 .~m(l 21. Note how extensive the cont-actpoint between the nasolacrimal duct and the inferior nasal meatus will be (ﬁg. 21). sld = superior lacrimal duct; ild = inferior l3.crirn:-11 duct; ls = lacrimal sac; nlcl = nas()lac1'i111al duct; Mr: = inferior Ixusal concha; i'rz.m = inferior nasal meatus. X 19.
Figs. 22-27 Photomicrographs of sections through the naso1a.c1'ima.l duct.
Fig. 22 From a. term child. Note that the connection between the na.solacrimal duct and the inferior nasal meatus is not yet established. "X 3.4.
Fig. 23 From a seven-month fetus. The connection between the nasolacrimal duct and the inferior nasal meatus is not established. X 6.1.
Fig. 24 From a term child. Barrier between the i'iasolacrima.l duct and the inferior nasal mcatus still present. Note the irregularity of the nasolacrimal duct. Compare with ﬁg. 30. X 2.9.
Fig. 25 From an adult aged sixty years. Note the circular and regular condition of the nasolaerirhal duct. Reconstruction seen in fig. 29. X 2.6.
Fig. 26 From an adult aged sixty-ﬁve years. Note the marked diverticulum (X) from the nasolacrimal duct. The nasolacrimal passages of this individual are seen in reconstruction in ﬁgs. 30 and 31. X 2.6.
Fig. 27 From an adult aged seventy years. In the region of the ostium of the common lam-imal duct. X 2.8.
Fig. 28 Photographs of transections of tho nasolacrimal duet at the point of entrance (ostium of nasolao1'ima.l duct) into the inferior nasal meatus. Note the different typos of ostia. (0). The sections are from adults and are magniﬁed from two to four times.
Fig. 29 Reconstruction of the nasolacrimal passages of an adult aged sixty Note the regularity of the nasolacrimal duct. and compare with ﬁgs. 30 X 3.2.
Figs. 30 and 31 Reconstruction of the nasolacrimal passages of an adult aged sixty-ﬁve years. Fig. 30 represents a medial View and Fig. 31 a lateral View of the reconstruction. Especially note the irregularity, clue to divorticula, of the nasolacrimal duct. The portions indicated in black at the inferior extremity of the nasolacrimal duct is a portion of the inferior nasal meatus. X 3.2. 22
of the ostia are doubtless due to the angle at which the original cord of cells meets the nasal mucous membrane. The position of contact also makes a difference. If the ostium is at the highest point of the inferior meatus, i.e., just caudal to the attachment of the inferior nasal concha to the lateral nasal wall, the opening of the nasolacrimal duct is usually a large, wide, open—mouthed ostium, unguarded by folds of mucous membrane (ﬁg. 28). If, on the other hand, the ostium is farther caudal 011 the lateral Wall it is usually slit—like and more or less guarded by folds of mucous membrane (ﬁgs. 28).
Even at term the embryo presents very irregular nasolac— rimal ducts (ﬁg. 24). After birth the Walls of the ducts become more and more regular. In the adult we very frequently ﬁnd large divertieula from the nasolacrimal duct, and these added to other irregularities give us at times extremely irregular lumina (ﬁgs. 30 and 31). On the other hand we ﬁnd adult ducts in which the lumina are very simple and regular (ﬁg. 29). The lumina of the adult laerimal ducts (lachrymal canaliculi) are generally more or less irregular.
- The strand of thickened epithelium—the anlage of the naso— laerimal passages along the ﬂoor of the rudimentary naso-optic ﬁssure becomes entirely separated from the surface, and for some time is wholly surrounded by mesenchymal tissue.
- The strand or cord of epithelial cells thus isolated from the surface is for some time Without a lumen.
- From the mother cord of cells both laerimal ducts and the nasal end of the nasolacrimal duet grow as sprouts. The cephalic portion of the laerimal sac also grows as a sprout from the mother cord.
- Considerable variation occurs in the development of the lacrimal ducts, i.e., as to number, time, and degree of development.
- The lumina of the several portions of the nasolacrimal passages are established in an irregular manner. The ocular end of the mother cord is the first to establish a lumen. The point of coalescence between the nasal end of the cord and the mucous membrane of the inferior nasal meatus is the last to become patent —the lumen here is established approximately at ‘term’ or even later. The horizontal portions of the lacrimal ducts establish lumina before the Vertical portions.
Wish to take this opportunity for expressing grateful acknowledgment to Professors Gage and Kerr for the material placed at my disposal in this investigation and for other courtesies extended. I am also indebted to Professor Ferris for reading the manuscript.
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Cite this page: Hill, M.A. (2019, June 16) Embryology Paper - The genesis and development of the nasolacrimal passages in man. Retrieved from https://embryology.med.unsw.edu.au/embryology/index.php/Paper_-_The_genesis_and_development_of_the_nasolacrimal_passages_in_man
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