Estudo da anatomia endoscópica da fossa lacrimal guiado por transiluminacão

Abstract

Dacryocyst orhinostomy is the treatment of choice for the obstruction of the lachrymal apparatus. At the end of last century, the development of the endoscopic instruments for nasosinusal surgery has made it possible to do it through the endoscopic pathway. Nonetheless, anatomical variations make it difficult to have reproducibility endonasaly. Aim: study the endoscopic anatomy of the lachrymal fossa through transillumination of the common canaliculus. Study design: experimental. Materials and Methods: we dissected 40 lachrymal pathways from 20 human cadavers, in three stages: 1. identification and dilation of the lachrymal canaliculus. 2 -Optic fiber beam introduction; 3 -endoscopic dissection of the lachrymal sac, describing its position. Results: the most frequent position of the lachrymal sac was between the free border of the middle turbinate and its insertion immediately underneath it. The maxillary line was seen in 95% of the cases. Septoplasty was needed in 12.5%, unicifectomy in 35% and middle turbinectomy in 7.5%. Conclusion: Although the lachrymal sac has a more frequent location, its position varied considerably. The transillumination of the common canaliculus proved useful, solving the problem of the anatomical variability.

Dacriocistorrinostomia endoscópica: nossa experiência e revisão de literatura

“…Yang et al (17) 1998 150 90 Cokkeser et al (7) 2000 51 88,2 Sham et al (18) 2000 17 88 Araujo Filho et al (2) 2004 17 82,3 Küpper et al (6) 2004 32 79,12 Ben Simon et al (19) ligaments and structures of the medial corner of the orbit, thus maintaining the physiological mechanisms of the lacrimal pump (13)(14)(15) . According to Cokkeser, dacryocystorhinostomy is successful in 70% to 95% (7) of cases, depending on a number of factors.…”