**1. Introduction**

44 Otolaryngology

Viducich, RA, Blanda, MP & Gerson, LW (1995). Posterior epistaxis: clinical features and

596, ISSN 0196-0644

acute complications. *Annals of Emergency Medicine* Vol. 25, No. 5, (May), pp. 592-

Early cases of dacryocystitis occur because of inflammation of the mucous membrane with resulting malfunction in the subepithelial cavernous body with occlusion of the lacrimal passage. Repeated attacks of dacryocystitis leads to structural epithelial changes, with loss of mucin, loss of TFF peptide producing goblet cells and columnar epithelial cells. Remodeling of the helical arrangement of the subepithelial connective tissue fibers leads to total fibrous closure. This then leads to epiphora.Primary acquired nasolacrimal duct obstruction (PANDO) is a syndrome of unknown origin.
