Valvular System of the Lacrimal Drainage Pathway and the Valve of Rosenmüller

The valves of the lacrimal drainage system are an enigma with a rich eponymous history. The evidence for the presence of valves have been studied or referred to in cadaveric investigations, real-time in-vivo, dacryocystography, nasal endoscopy, dacryoendoscopy, and ultrastructurally (Ali et al., 2015, Ali and Paulsen, 2019a, Aubaret, 1908, Malik et al., 2020, Singh et al., 2022, Yedavalli et al., 2019a, Yedavalli et al., 2019b). The unidirectional flow of tears along with the ultrastructural demonstration of distinctive mucosal folds on the luminal surface has rekindled an interest in them. The eponymous valves are several, such as the Bochdalek and Foltz at the inferior and superior puncta, Rosenmüller and Huschke at the common canaliculus-lacrimal sac junction, Aubaret, Beraud or Krause at the level where the NLD begins, Heinlein, Hyrtl-Vlacovitch within the proximal NLD, Taillefer within the NLD, and Hasner or Cruveilhier or Bianchi at the inferior tip of the NLD (Aubaret, 1908, Bedrossian, 2006, Chen, 2001, Kurihashi et al., 1991; Murube, 1981; Tucker et al., 1996; Yedavalli et al., 2019a, Yedavalli et al., 2019b). The first in vivo direct demonstration of the valve of Rosenmüller and its functions has laid to rest some of the controversies of its existence and that of the valve of Huschke (Ali, 2020a). The dynamic assessment of the valve of Rosenmüller has shown a well-defined functional role in the facilitation of unidirectional tear flow. The present mini review describes the embryological aspects, brief overview of the eponymous valves, techniques for their identification along with recent structural and functional aspects of the valve of Rosenmüller.

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