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Lacrimal Fossa

fossa sacci lacrimalis

The lacrimal fossa is a vertical groove in the anteromedial orbital wall formed by the anterior lacrimal crest of the maxillary frontal process (anteriorly) and the posterior lacrimal crest of the lacrimal bone (posteriorly), housing the lacrimal sac. The fossa continues inferiorly as the nasolacrimal canal. The medial canthal tendon splits around it with anterior and posterior limbs.

Region: Head & Skull

Clinical Relevance

Clinical Notes

The lacrimal fossa is the operative target in dacryocystorhinostomy (DCR) for nasolacrimal duct obstruction, where the lacrimal sac is marsupialized into the nasal cavity through a bony window created in the lacrimal fossa. External DCR creates the window directly over the fossa through a skin incision; endonasal DCR approaches from the nasal side through the lateral nasal wall. The anterior lacrimal crest provides the bony anchor for the anterior limb of the medial canthal tendon. Lacrimal sac tumours arising in this fossa are rare but important.

Pathology

Common Injuries & Conditions

Dacryocystorhinostomy Through the Lacrimal Fossa

External DCR for nasolacrimal duct obstruction creates a bony ostium in the lacrimal fossa by removing bone from both the lacrimal bone and the frontal process of the maxilla, exposing the lacrimal sac and marsupialization of its medial wall into the nasal cavity via a mucosal anastomosis with silicone stenting.