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Paper Information

Journal:   JOURNAL OF OPHTHALMIC AND VISION RESEARCH   JULY 2011 , Volume 6 , Number 3; Page(s) 219 To 224.
 
Paper: 

SURGICAL TECHNIQUE: NON-ENDOSCOPIC MECHANICAL ENDONASAL DACRYOCYSTORHINOSTOMY

 
 
Author(s):  ETEZAD RAZAVI MOHAMMAD*, NOOROLLAHIAN MORTEZA, ESLAMPOOR ALIREZA
 
* MASHHAD EYE RESEARCH CENTER, KHATAM-AL-ANBIA HOSPITAL, GHARANAI BLVD., MASHHAD 91959, IRAN
 
Abstract: 

To circumvent the disadvantages of endoscopic dacryocystorhinostomy such as small rhinostomy size, high failure rate and expensive equipment, we hereby introduce a modified technique of non-endoscopic mechanical endonasal dacryocystorhinostomy (NE-MEDCR). Surgery is performed under general anesthesia with local decongestion of the nasal mucosa. A 20-gauge vitrectomy light probe is introduced through the upper canaliculus until it touches the bony medial wall of the lacrimal sac. While directly viewing the transilluminated target area, a nasal speculum with a fiber optic light carrier is inserted. An incision is made vertically or in a curvilinear fashion on the nasal mucosa in the lacrimal sac down to the bone using a freer periosteum elevator.
Approximately 1 to 1.5 cm of nasal mucosa is removed with Blakesley forceps. Using a lacrimal punch, the thick bone of the frontal process of the maxilla is removed and the inferior half of the sac is uncovered. The lacrimal sac is tented into the surgical site with the light probe and its medial wall is incised using a 3.2 mm keratome and then excised using the Blakesley forceps. The procedure is completed by silicone intubation. The NE-MEDCR technique does not require expensive instrumentation and is feasible in any standard ophthalmic surgical setting.

 
Keyword(s): ENDONASAL DACRYOCYSTORHINOSTOMY, MECHANICAL, NASOLACRIMAL DUCT OBSTRUCTION
 
References: 
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