99m TcO4 Sialoscintigraphy in Pre and Post-Transplant Evaluation of Submandibular Gland Transfer in a Case of Bilateral Congenital Alacrimia

Isolated bilateral congenital alacrimia is an exceedingly rare anomaly, especially without any family history. The majority of cases are associated with genetic disorders or underlying systemic syndromes. Causes of alacrima range from absence or tear hyposecretion to agenesis or improper development of lacrimal gland ducts and associated structures. We present this rare case of severe dry eyes in a newborn with associated conjunctival cicatrisation planned for autologous bilateral submandibular gland transfer, as a vision saving surgery. The incremental role of pre and postoperative sialoscintigraphy and a modification of the procedure post gland transfer is also being highlighted.