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The dual pathway model posits that spontaneous and volitional laughter are voiced using distinct production systems, and perceivers rely upon these system-related cues to make accurate judgments about relationship status. Yet, to our knowledge, no empirical work has examined whether raters can differentiate laughter directed at friends and romantic partners and the cues driving this accuracy. In Study 1, raters (

Infidelity is rooted in secrecy and deceit. The deception can include both falsification (i.e., active lying) and concealment (i.e., omission of information) of extrapair liaisons. Infidelity deception can also take the form of engagement in secret online indiscretions. Those who are more likely to engage in infidelity deception possess certain qualities related to high sociosexuality and Machiavellianism, and also have a history of serial infidelity. Given the secretive nature of infidelity, there are strategies that individuals use to uncover secrets. These cheater detection strategies may involve active information seeking (e.g., snooping on partner) or the use of implicit cues such as assessing subtle behavioral changes or examining the facial and vocal patterns of a cheater. Deception can also be directed toward the extrapair partner to attain or maintain the extradyadic relationship. Further, there is deception involved with a potential consequence of infidelity—cuckoldry; misattributed paternity is definitive proof of infidelity that has been kept hidden. Even after a sexual infidelity has been exposed, the responses presented to one’s partner may not always be laden with truth and transparency with regard to the unfaithful acts and the feelings toward the extrapair partner. The motivation to maintain an in-pair partnership and the amount of knowledge already gathered by an in-pair partner about the transgressions can facilitate different incentives for exposing the disloyalty and/or offering concessions. This chapter presents an overview of the literature that examines the secret and deceptive aspects of infidelity.

We examined sex differences in preferences for sexual variety and novelty to determine whether the Coolidge effect plays a role in human sexuality. In two experimental studies that employed different manipulations, we found converging evidence that men showed a greater preference for variety in potential short-term mates than did women. In the first study, men (n = 281) were more likely than women (n = 353) to select a variety of mates when given the opportunity to distribute chances to have sex with different individuals in hypothetical situations. This sex difference was evident regardless of the targets’ attractiveness and age. Further, men found it more appealing if their committed romantic/sexual partners frequently changed their physical appearance, while women reported that they modified their physical appearance more frequently than did men, potentially appealing to male desires for novelty. In the second study, when participants were given a hypothetical dating task using photographs of potential short-term mates, men (n = 40) were more likely than women (n = 56) to select a novel person to date. Collectively, these findings lend support to the idea that sex differences in preferences for sexual variety and novelty are a salient sex-specific evolved component of the repertoire of human mating strategies.

We sought to examine perceived nervous reactions when first interacting with a particularly attractive person/potential romantic partner. From a theoretical standpoint, we cogitate on the possible adaptive nature of these reactions that appear seemingly counterproductive for future mating success. We documented 280 participants’ retrospective self-reports of experiencing a variety of physiological, vocal, and behavioral reactions during an initial encounter with a person they found highly attractive. We also asked participants to rate the reactions of others that they used to determine if another person was attracted to them. Participants reported most frequently experiencing increased attentiveness, smiling, staring, heart rate, giggling/laughter, blushing, and difficulty concentrating during this first encounter. Both sexes reported speaking faster and being less able to express themselves clearly, and women reported using a higher pitch and having a more unsteady tone of voice during an initial encounter of attraction. Further, participants reported observing similar nervous reactions by others whom they perceived were attracted to them. These findings were examined while considering individual differences in sociosexual orientation (i.e., propensity toward uncommitted sex), self-perceived mate value, empathy, and gender. Participants reported that they did, indeed, experience a cluster of anxiety-related physiological and behavioral reactions during an initial encounter with someone they found highly attractive. Although appearing nervous and awkward during an initial encounter with an attractive other may seem counterproductive for future mating success, we discuss potential adaptive functions for displaying these responses.

The human voice is dynamic, and people modulate their voices across different social interactions. This article presents a review of the literature examining natural vocal modulation in social contexts relevant to human mating and intrasexual competition. Altering acoustic parameters during speech, particularly pitch, in response to mating and competitive contexts can influence social perception and indicate certain qualities of the speaker. For instance, a lowered voice pitch is often used to exert dominance, display status and compete with rivals. Changes in voice can also serve as a salient medium for signalling a person's attraction to another, and there is evidence to support the notion that attraction and/or romantic interest can be distinguished through vocal tones alone. Individuals can purposely change their vocal behaviour in attempt to sound more attractive and to facilitate courtship success. Several findings also point to the effectiveness of vocal change as a mechanism for communicating relationship status. As future studies continue to explore vocal modulation in the arena of human mating, we will gain a better understanding of how and why vocal modulation varies across social contexts and its impact on receiver psychology. This article is part of the theme issue ‘Voice modulation: from origin and mechanism to social impact (Part I)’.

Objective: To explore the relationship between symptoms of attention-deficit hyperactivity disorder (ADHD), symptoms of binge eating disorder, and body mass index (BMI) among students at a southern university. Participants: Two hundred seventy-seven college students. Methods: Between January 31, 2013 and March 27, 2013, participants completed the Adult ADHD Self-Report Scale (ASRS) Screener and the Binge Eating Scale (BES) in addition to permitting researchers to measure their height and weight. Results: Higher ASRS scores, higher BMIs, and lower BES scores were observed among men. Among both men and women, BES scores were positively correlated with BMI and ASRS scores; however, the correlation between ASRS and BMI was not significant. Conclusion: Binge eating disorder symptomatology was associated with increased ADHD symptomatology and a higher BMI among both men and women. Among students presenting with obesity or ADHD, screening for binge eating may assist with the identification of problematic eating behaviors.

Facial symmetry is an index of developmental stability and shows a positive correlation with attractiveness assessment. However, the appearance of one’s facial symmetry is not always static and may change when there is facial movement while a person is speaking. This study examined whether viewing a dynamic image of a person speaking (where facial symmetry may alter) would elicit a different perception of attractiveness than viewing a static image of that person as a still photo. We examined changes in both measured and perceived facial symmetry in relation to attractiveness perception. We found that when facial movements created an appearance of overall greater facial symmetry while a person was speaking in a video, the person was rated as being more attractive than as a still photo. Likewise, those with facial movements measured and perceived as less symmetrical while speaking were rated as less attractive in a video clip than still photo. By examining the perception of faces in motion as we typically encounter others in real life rather than considering only static photos, we have extended the ecological validity of the study of the perception of bilateral symmetry in humans as it relates to attractiveness.

Previous research suggests that binge drinking among young men serves as a “costly signal” to potential mates, such that the binge drinker is capable of bearing the harmful consequences of alcohol consumption. Here, we propose that binge drinking among young adults is conditionally dependent upon the signaler’s willingness to take risks, which is influenced by the local operational sex ratio (OSR). Using archived binge drinking estimates from 2009 to 2012 and Census Bureau records of OSRs, we tested the relationship between OSR and binge drinking rates at the county level across 3,143 U.S. counties against hypotheses drawn from evolutionary theory. Results from our mixed-effects models revealed that a higher overall OSR (i.e., more eligible men compared to women) was associated with higher male binge drinking rates but lower female binge drinking rates. A higher OSR particularly in the 20–29 and 50+ age groups predicted higher male binge drinking rates but lower female binge drinking rates. Our findings generally support predictions derived from evolutionary theory and suggest that binge drinking may function as a costly sexual signal, conditionally regulated by age and the local sex ratio.

Since the very nature of an Evolutionary Studies program is interdisciplinary, it stands to reason that building such a program at any institution would entail the involvement of several disciplines across the curriculum. The fewer faculty members, course offerings, and resources at small liberal arts colleges can pose as obstacles in the development of such a program. However, by reaching out to the few faculty members teaching evolutionary studies, the first step of its development began. From there, both the involvement of other disciplines and a heightened student, faculty, and administrative awareness was needed. Instrumental components in building this program have included speaker events, student participation at evolutionary conferences and workshops, student involvement in research, and the development of new courses and a minor degree. This chapter discusses the successes and barriers in developing an interdisciplinary Evolutionary Studies program at a small liberal arts college.

This study experimentally tested whether individuals have a tendency to associate attractive voices with attractive faces and, alternately, unattractive voices with unattractive faces. Participants viewed pairings of facial photographs of attractive and unattractive individuals and had listened to attractive and unattractive voice samples and were asked to indicate which facial picture they thought was more likely to be the speaker of the voice heard. Results showed that there was an overall tendency to associate attractive voices with attractive faces and unattractive voices with unattractive faces, suggesting that a “what-sounds-beautiful-looks-beautiful” stereotype exists. Interestingly, there was an even stronger propensity to pair unattractive voices to unattractive faces than for the attractive voice–face matching.

We examined sex differences in preferences for sexual variety and novelty to determine whether the Coolidge effect plays a role in human sexuality. In two experimental studies that employed different manipulations, we found converging evidence that men showed a greater preference for variety in potential short-term mates than did women. In the first study, men (n = 281) were more likely than women (n = 353) to select a variety of mates when given the opportunity to distribute chances to have sex with different individuals in hypothetical situations. This sex difference was evident regardless of the targets' attractiveness and age. Further, men found it more appealing if their committed romantic/sexual partners frequently changed their physical appearance, while women reported that they modified their physical appearance more frequently than did men, potentially appealing to male desires for novelty. In the second study, when participants were given a hypothetical dating task using photographs of potential short-term mates, men (n = 40) were more likely than women (n = 56) to select a novel person to date. Collectively, these findings lend support to the idea that sex differences in preferences for sexual variety and novelty are a salient sex-specific evolved component of the repertoire of human mating strategies.

Unsafe food handling behaviors are common among consumers, and, given the venue, individuals attending a tailgating event may be at risk for foodborne illness. The objective of this study was to measure the association between Health Belief Model variables and self-reported usual food handling behaviors in a convenience sample of men and women at a tailgate event. Participants (n = 128) completed validated subscales for self-reported food handling behaviors (i.e., cross-contamination, sanitation), perceived threat of foodborne illness (i.e., perceived severity, perceived susceptibility), and safe food handling cues to action (i.e., media cues, educational cues). Perceived severity of foodborne illness was associated with safer behaviors related to sanitation (r = 0.40; P0.001) and cross-contamination (r = 0.33; P = 0.001). Perceived severity of foodborne illness was also associated with exposure to safe food handling media cues (r = 0.20; P = 0.027) but not with safe food handling educational cues. A large proportion of participants reported that they never or seldom (i) read newspaper or magazine articles about foodborne illness (65.6%); (ii) read brochures about safe ways to handle food (61.7%); (iii) see store displays that explain ways to handle food (51.6%); or (iv) read the "safe handling instructions" on packages of raw meat and poultry (46.9%). Perceived severity of foodborne illness was positively related to both dimensions of safe food handling as well as with safe food handling media cues. Except for the weak correlation between media cues and perceived severity, the relationships between safe food handling cues and perceived threat, as well as between safe food handling cues and behaviors, were nonsignificant. This finding may be due, in part, to the participants' overall low exposure to safe food handling cues. The overall results of this study reinforce the postulate that perceived severity of foodborne illness may influence food handling behaviors.

Evidence suggests that many physical, behavioral, and trait qualities can be detected solely from the sound of a person’s voice, irrespective of the semantic information conveyed through speech. This study examined whether raters could accurately assess the likelihood that a person has cheated on committed, romantic partners simply by hearing the speaker’s voice. Independent raters heard voice samples of individuals who self-reported that they either cheated or had never cheated on their romantic partners. To control for aspects that may clue a listener to the speaker’s mate value, we used voice samples that did not differ between these groups for voice attractiveness, age, voice pitch, and other acoustic measures. We found that participants indeed rated the voices of those who had a history of cheating as more likely to cheat. Male speakers were given higher ratings for cheating, while female raters were more likely to ascribe the likelihood to cheat to speakers. Additionally, we manipulated the pitch of the voice samples, and for both sexes, the lower pitched versions were consistently rated to be from those who were more likely to have cheated. Regardless of the pitch manipulation, speakers were able to assess actual history of infidelity; the one exception was that men’s accuracy decreased when judging women whose voices were lowered. These findings expand upon the idea that the human voice may be of value as a cheater detection tool and very thin slices of vocal information are all that is needed to make certain assessments about others.

Evidence suggests that people can manipulate their vocal intonations to convey a host of emotional, trait, and situational images. We asked 40 participants (20 men and 20 women) to intentionally manipulate the sound of their voices in order to portray four traits: attractiveness, confidence, dominance, and intelligence to compare these samples to their normal speech. We then asked independent raters of the same- and opposite-sex to assess the degree to which each voice sample projected the given trait. Women’s manipulated voices were judged as sounding more attractive than their normal voices, but this was not the case for men. In contrast, men’s manipulated voices were rated by women as sounding more confident than their normal speech, but this did not hold true for women’s voices. Further, women were able to manipulate their voices to sound just as dominant as the men’s manipulated voices, and both sexes were able to modify their voices to sound more intelligent than their normal voice. We also assessed all voice samples objectively using spectrogram analyses and several vocal patterns emerged for each trait; among them we found that when trying to sound sexy/attractive, both sexes slowed their speech and women lowered their pitch and had greater vocal hoarseness. Both sexes raised their pitch and spoke louder to sound dominant and women had less vocal hoarseness. These findings are discussed using an evolutionary perspective and implicate voice modification as an important, deliberate aspect of communication, especially in the realm of mate selection and competition.

Previous research has largely ignored examining nipple erection in nonsexual situations. We hypothesized that both women and men experience nonsexual nipple erection under emotional and somatic (nonsexual) conditions that trigger autonomic arousal and sought to document nonsexual triggers and instances of nipple erection in various contexts. As predicted, self-reports from 181 college students indicated that individuals experience nipple erection when under stress, frightened, and anxious. Participants also reported often experiencing nipple erection concurrently with piloerection (“goose bumps”). In addition, participants reported nipple erection self-vigilance and concealment in nonsexual situations, suggesting awareness that nipple erection may communicate a target’s emotional and somatic arousal. Implications and limitations to these exploratory findings are discussed.

This study examined how perceptions of a person’s sexual orientation may be influenced by facial bilateral symmetry and sexually-dimorphic facial proportions thought to be influenced by sex hormones. Pictures of individuals who self-identified their sexual orientation were measured for facial symmetry and certain facial proportions. Independent raters were asked to identify the sexual orientation of those in the pictures on a continuum scale. Self-identified heterosexuals had facial measures that were less asymmetrical than homosexuals. The more likely raters perceived someone to hold a heterosexual orientation, the more symmetrical that person’s facial features were. There were few differences seen for the individual, sexually-dimorphic trait measurements between self-identified heterosexual and homosexual individuals; however, an examination of a composite of traits showed that heterosexual men had greater overall masculine facial features than did gay men. Furthermore, the more masculine a male’s overall facial features were, the more likely he was perceived as being heterosexual. These findings suggest that individuals may be using cues of facial symmetry and male facial masculinity to judge one’s sexual orientation.

This study examined self-recognition processing in both the auditory and visual modalities by determining how comparable hearing a recording of one's own voice was to seeing photograph of one's own face. We also investigated whether the simultaneous presentation of auditory and visual self-stimuli would either facilitate or inhibit self-identification. Ninety-one participants completed reaction-time tasks of self-recognition when presented with their own faces, own voices, and combinations of the two. Reaction time and errors made when responding with both the right and left hand were recorded to determine if there were lateralization effects on these tasks. Our findings showed that visual self-recognition for facial photographs appears to be superior to auditory self-recognition for voice recordings. Furthermore, a combined presentation of one's own face and voice appeared to inhibit rather than facilitate self-recognition and there was a left-hand advantage for reaction time on the combined-presentation tasks.

The Post-Coital Time Interval (PCTI) may be particularly important for pair-bonding and establishing relationship commitment. Women have greater incentives for establishing relationship commitment than men because of their greater necessary investment in offspring and the benefits of long-term paternal investment. Thus, sex differences in PCTI experiences may emerge based on sex differences in reproductive strategies. We generated 16 items to assess PCTI experiences and extracted three factors related to: 1) satisfaction and bonding, 2) a desire for more signals of bonding and commitment from one’s partner, and 3) romantic partners having a greater interest in talking about relationship issues. Consistent with our predictions, women’s satisfaction with PCTI experiences was inversely related to the extent to which they desired greater bonding and commitment signals from their partner, whereas men’s satisfaction with PCTI experiences was inversely related to the extent to which their partners’ had greater interests in talking about relationship issues. These dimensions were also related to other indicators of reproductive strategies, including attachment style.

Although very distinct emotions, facial expressions of those who are experiencing pain/agony appear surprisingly similar to those who are experiencing heightened sexual pleasure. We investigated whether sex differences exist between distinguishing facial photos of males and females expressing either pain or sexual pleasure. Photographs obtained from the internet of individuals expressing either emotion were individually shown to ninety-one participants in a slideshow, and participants were asked to identify the emotion. Overall, participants were more able to correctly identify an expression of pain as opposed to sexual pleasure. Participants also showed the highest degree of accuracy when it came to identifying females showing expressions of pain, but were the least accurate at identifying females with expressions of sexual pleasure, and this effect was more pronounced for female raters. Furthermore, participants took longer to respond to male pictures than to female pictures. These findings are discussed in terms of how sex differences in the perception of these facial expressions may be adaptive. (PsycINFO Database Record (c) 2010 APA, all rights reserved) (journal abstract)

Previous research (Hughes et al. Evolution and Human Behavior 23:173–180, 2002) has shown that ratings of voice attractiveness are negatively correlated to fluctuating asymmetry (FA, a measure of developmental stability and fitness) but are unrelated to the second to fourth digit ratio (2D:4D, a measure of prenatal sex hormone exposure). In the present study, we considered ratings of these voices based on a number of other descriptive traits that may be particularly important in mate selection. Men with voices rated as approachable, intelligent, sexy, and warm showed greater bilateral body symmetry. Women with voices rated as approachable, sexy, and most likely to get dates also tended to be more symmetrical. Furthermore, voices rated as dominant and mature were negatively correlated to 2D:4D ratios in women, suggesting an effect of exposure to higher levels of prenatal androgen. Unlike subjective ratings, objective measures of voice obtained through spectrogram analyses did not account for much variance in either symmetry or digit ratios. These findings implicate the perceptual qualities of voice as a salient marker of underlying genetic quality and viability.

We investigated the relationship between ratings of voice attractiveness and sexually dimorphic differences in shoulder-to-hip ratios (SHR) and waist-to-hip ratios (WHR), as well as different features of sexual behavior. Opposite-sex voice attractiveness ratings were positively correlated with SHR in males and negatively correlated with WHR in females. For both sexes, ratings of opposite-sex voice attractiveness also predicted reported age of first sexual intercourse, number of sexual partners, number of extra-pair copulation (EPC) partners, and number of partners that they had intercourse with that were involved in another relationship (i.e., were themselves chosen as an EPC partner). Coupled with previous findings showing a relationship between voice attractiveness and bilateral symmetry, these results provide additional evidence that the sound of a person's voice may serve as an important multidimensional fitness indicator.

We investigated sex differences in post-copulatory mate guarding behaviors, jealous reactions to opposite- versus same-sex infidelity, and preferences for multiple concurrent sex partners. Results ...

Differences exist between males and females in fat distribution, skeletal morphology, muscle mass, and body shape. We investigated sex differences in shoulder to hip ratios (SHR) and waist to hip ratios (WHR), and their relationships to different features of sexual behavior. Males with high SHR and females with low WHR reported sexual intercourse at an earlier age, more sexual partners, more extra-pair copulations (EPC), and having engaged in more instances of intercourse with people who were involved in another relationship (i.e., having themselves been EPC partners). The predictive value of these morphological features was highly sex-specific.

Low fluctuating asymmetry (FA, a measure of deviation from bilateral symmetry) appears to be a phenotypic marker of reproductive viability and health. In the present study, we investigated whether ratings of voice attractiveness were correlated with variations in FA. Several bilateral traits were measured to calculate a FA index and independent raters who did not know and never saw the subjects assessed the attractiveness of recordings of each subject's voice. Voices of subjects with greater bilateral symmetry were rated as more attractive by members of both sexes than those with asymmetrical traits.

Previous research shows that the human voice can communicate a wealth of nonsemantic information; preferences for voices can predict health, fertility, and genetic quality of the speaker, and people often use voice attractiveness, in particular, to make these assessments of others. But it is not known what we think of the attractiveness of our own voices as others hear them. In this study eighty men and women rated the attractiveness of an array of voice recordings of different individuals and were not told that their own recorded voices were included in the presentation. Results showed that participants rated their own voices as sounding more attractive than others had rated their voices, and participants also rated their own voices as sounding more attractive than they had rated the voices of others. These findings suggest that people may engage in vocal implicit egotism, a form of self-enhancement.

Summary There has been a major paradigm shift in blepharoplasty surgery because of the recent technologic advances with endoscopic surgery, laser resurfacing, and fat transfer. Education and communication are of paramount importance to help eliminate confusion, frustration, misunderstandings, and patient disappointment. A discussion about the associated risks and benefits of the proposed procedures and the expected healing times is imperative. Preoperative and postoperative instructions along with copies of the surgical consents may be given to patients to study at home before surgery. Evaluation of the cosmetic blepharoplasty patient must include the upper and midface, the eyelids and eyes, and the skin. The best choice for each patient is individualized based on their dislikes, the physical examination, their tolerance for potential risks, the healing time, and their budget. Putting all this together is a fine art in providing patients with the difference between good, better, and best in lid rejuvenation.

Research has documented the tendency for individuals to change their voices as a function of different emotional and motivational states, but little attention has been devoted to examining voice modulation in romantic relationships. The present research was conducted to determine (1) the way in which individuals alter their voices when speaking to romantic partners versus friends and (2) if independent raters perceive these differences. Independent raters (N = 80) listened to vocal clips obtained from telephone calls directed toward close same-sex friends and romantic partners. For several clips, raters were able to identify conversational partner (romantic versus friend) with greater than chance accuracy, and this accuracy was positively correlated with vocal pitch and perceived romantic interest. In addition, raters who listened to content-filtered clips judged callers less favorably when talking to their romantic partners than their friends. Results are interpreted in light of the ‘‘longing’’ but vulnerable condition of intense romantic love, and integrated into affection exchange theory and communication accommodation theory., https://www.researchgate.net/profile/Sally_Farley/publication/273447618_Farley_Hughes_LaFayette_copy/links/5501aeb00cf24cee39f862f7/Farley-Hughes-LaFayette-copy.pdf

Few empirical studies have been devoted to exploring behaviors occurring immediately following sexual intercourse. Therefore, this study conducts an exploratory investigation of various post-coital behaviors that the authors propose may reflect the divergent adaptive reproductive strategies of each sex as understood from an evolutionary perspective. An online questionnaire was administered to 170 individuals examining sex differences in post-coital compared to pre-coital activities related to pair-bonding with long-term mates, as well as a variety of common post-coital activities comparing short- and long-term mating contexts. It was found that females were more likely than males to initiate and place greater importance on several behaviors related to intimacy and bonding following sex with long-term partners. Males were more likely to initiate kissing before sex, and females after sex. Intimate talk and kissing were rated by both sexes as more important before intercourse with a long-term partner, whereas cuddling and professing one's love was rated more important after sex. In a second set of more specific post-coital behaviors, females were more likely to engage in post-coital behaviors related to bonding with both short- and long-term partners, whereas males were more likely to engage in ones that were extrinsically rewarding or increased the likelihood of further coital acts.

In response to a commentary provided by Uttl and Morin (2010) regarding the recent study by Hughes and Nicholson (2010) , we evaluate their suggestion to modify our study’s design to reduce ceiling effects (similar to that of Rosa, Lassonde, Pinard, Keenan, & Belin, 2008 ). Also, the commentators failed to take into account our data on reaction times (a measure that is arguably less affected by ceiling effects), which help substantiate our conclusions regarding self-face and self-voice recognition. This rejoinder encourages readers to consider the relevance of the ecological validity of Hughes and Nicholson’s findings.

An abundance of unwanted sexual opportunities perpetrated by insensitive, physically and sexually abusive men may be a factor in the expression of homosexuality in some women. In the present study, we examined self-reports of dating histories, sexual experiences, and physical and sexual abuse among lesbians and heterosexual women. Lesbians with prior heterosexual experience reported more severe and more frequent physical abuse by men. Lesbians also reported more instances of forced, unwanted sexual contact perpetrated by men, and this sexual abuse occurred at a significantly earlier age. These data show that adverse experiences with the opposite sex are more common in lesbians than heterosexual women, and therefore negative heterosexual experiences may be a factor in the expression of a same-sex sexual orientation in women. We propose an evolutionary psychological interpretation of this phenomenon based on the cardinally different mating strategies of women and men that have evolved for maximizing the likelihood of reproduction.

Of 142 children who underwent major lacrimal surgery (160 dacryocystorhinostomies, one congenital fistula excision, one dacryocystectomy, and one canaliculostomy), 49 had congenital nasolacrimal duct obstruction (34%). Lacrimal obstruction was also associated with canaliculitis, punctal agenesis, trauma, congenital fistula, dacryocystitis, craniofacial defects, and functional eyelid abnormalities. Although the timing and technique of the surgery varied according to the abnormalities, an overall functional success rate of 90% (144 of 160 procedures) was achieved.