{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,7]],"date-time":"2025-08-07T21:21:07Z","timestamp":1754601667585,"version":"3.28.0"},"reference-count":56,"publisher":"Georg Thieme Verlag KG","issue":"03","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Laryngorhinootologie"],"published-print":{"date-parts":[[2024,3]]},"abstract":"<jats:title>Zusammenfassung<\/jats:title><jats:p>Konkremente des Tr\u00e4nenapparates, sog. Dakryolithen, k\u00f6nnen an unterschiedlichen Lokalisationen auftreten und f\u00fchren zu verschiedenen klinischen Zeichen. Gemeinsam ist das Auftreten chronischer Entz\u00fcndungen, die akut exazerbieren k\u00f6nnen. Anhand einer Literaturrecherche sowie deskriptiver Vorstellung und Korrelation der Klinik mit histopathologischen Befunden sollen die wichtigsten Informationen zur Epidemiologie, \u00c4tiopathogenese, Zusammensetzung, Histologie und Therapie gegeben werden. Weiterhin werden die bekannten Einflussfaktoren zur Lithogenese im Tr\u00e4nensack zusammengefasst. Konkremente der Tr\u00e4nendr\u00fcse zeigen eine Schwellung im Bereich des lateralen Kanthus. Die h\u00e4ufig nur mit leichten Schmerzen einhergehende Ver\u00e4nderung f\u00fchrt oft auch zu einer umschriebenen konjunktivalen Hyper\u00e4mie. Histologisch ist das Gewebe der Tr\u00e4nendr\u00fcse von einer akut-erosiven bis chronischen Entz\u00fcndungsreaktion gekennzeichnet. Die Konkremente bestehen aus amorphem Material. Das entz\u00fcndliche Infiltrat ist von neutrophilen Granulozyten dominiert. Tr\u00e4nenr\u00f6hrchensteine sind in hohem Ma\u00dfe mit dem klinischen Bild einer chronischen Kanalikulitis assoziiert. Klinisch liegen zumeist eine Epiphora und ein purulenter Sekretausfluss im Bereich des betroffenen Tr\u00e4nenr\u00f6hrchens vor. Die Konkremente der Tr\u00e4nenr\u00f6hrchen weisen typischerweise Actinomyces-Drusen auf. Das umgebende Gewebe reagiert mit einer plasmazellul\u00e4ren sowie granulozyt\u00e4ren Infiltration. Dakryolithen (Konkremente des Tr\u00e4nensackes) manifestieren sich im Rahmen einer Dakryozystitis, wobei hier sowohl akute als auch chronische Entz\u00fcndungen vorkommen. Sie werden in bis zu 18% der Dakryozystorhinostomien gefunden und stellen eine gro\u00dfe diagnostische Herausforderung dar. Wiederkehrende episodenhafte Epiphora mit mukopurulenter Sekretion und akuter Dakryozystitis sind typisch. Zumeist besteht eine Sp\u00fclbarkeit der ableitenden Tr\u00e4nenwege. Histologisch imponiert ein lymphozyt\u00e4res Infiltrat mit submuk\u00f6ser Fibrose. Unmittelbar angrenzend zu den Konkrementen finden sich Zeichen einer akuten Entz\u00fcndungsreaktion. Das therapeutische Mittel der Wahl ist die Extraktion der Konkremente und die Beseitigung der Tr\u00e4nenabflussst\u00f6rung, da hierin ein wichtiger Faktor zur Entstehung gesehen wird.<\/jats:p>","DOI":"10.1055\/a-2192-3865","type":"journal-article","created":{"date-parts":[[2023,11,21]],"date-time":"2023-11-21T23:55:46Z","timestamp":1700610946000},"page":"187-195","source":"Crossref","is-referenced-by-count":1,"title":["Konkremente des Tr\u00e4nenapparates"],"prefix":"10.1055","volume":"103","author":[{"given":"Marlene","family":"Stein","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik und Poliklinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Halle (Saale), Halle (Saale), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel","family":"Bethmann","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arne","family":"Viestenz","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik und Poliklinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinikum Halle (Saale), Halle (Saale), Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Claudia","family":"Wickenhauser","sequence":"additional","affiliation":[{"name":"Institut f\u00fcr Pathologie, Martin-Luther-Universitat Halle-Wittenberg, Halle, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans-Gert","family":"Struck","sequence":"additional","affiliation":[{"name":"Universit\u00e4tsklinik und Poliklinik f\u00fcr Augenheilkunde, Martin-Luther-Universit\u00e4t Halle-Wittenberg, Halle \/ Saale, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jens","family":"Heichel","sequence":"additional","affiliation":[{"name":"Klinik f\u00fcr Augenheilkunde, Universit\u00e4tsklinik Halle, Halle, 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