Loss of Reflex Tearing: An Expected Consequence of Juvenile Nasopharyngeal Angiofibroma

To report the loss of reflex tearing after surgical treatment of juvenile nasopharyngeal angiofibroma (JNA). A retrospective case series of 8 patients with surgical extirpation of JNA from 1995 to 2003 in a major teaching hospital setting was studied for symptomatic xerophthalmia. One patient was lost to follow-up. Four of the remaining 7 patients reported a dry ipsilateral eye after surgical treatment of JNA. The location of the pterygopalatine ganglion and its associated fibers in the pterygopalatine fossa is directly adjacent to the location of origin of JNA. Lacrimal innervation passes through the pterygopalatine ganglion. Given the extensive nature of advanced JNA and mandate for complete surgical excision, lacrimal dysfunction should be considered an expected consequence of surgery. The loss of reflex tearing has not been reported as a consequence of JNA or its surgical treatment. EBM Rating: C.