Endoillumination-Guided Intranasal Microscopic Dacryocystorhinostomy for Difficult Cases

Abstract

Purpose: This prospective study explores the efficacy of a combined approach by intranasal microsurgical dacryocystorhinostomy and fiberglass endoillumination of the tear passage for difficult cases of lacrimal sac or nasolacrimal duct obstruction. Methods: Microscopic dacryocystorhinostomy was performed in 67 patients with lacrimal obstruction and for revision of external dacryocystorhinostomy. Improved endonasal visualization by microscope and combination with endoillumination of the tear passage allows instant identification and opening of the lacrimal nasal sac without skin incision. Silicon tubes were used for bicanalicular intubation. The patients were prospectively observed for at least 1 year. Results: The operation was well tolerated by all patients. In 95%, a persistently open tear passage was successfully established. No serious complications were observed. Conclusion: Endoillumination of the lacrimal sac is useful for locating the sac precisely and refining the endonasal operation technique.

Endoscopic Dacryocystorhinostomy as Treatment for Lower Lacrimal Pathway Obstructions in Adults: Review Article

“…Today, endoillumination is a widely used method for locating the lacrimal sac with different endoscopic techniques. 24 , 25 Many investigators claim that the axilla of the middle turbinate is a landmark for the roof of the lacrimal sac. 22 , 26 However, Wormald et al , 27 in an anatomic study with 47 patients, showed that the major part of the lacrimal sac (10 mm) is situated above the axilla of the middle turbinate and that it extends 1–2 mm below this landmark ( Fig.…”

Endonasale mikroskopische Dakryozystorhinostomie mit Endoillumination und Intubation bei Patienten mit kombinierten Tränenwegspathologien oder Revisionen

“…l " Dakryozystorhinostomie l " Transillumination l " Tränenwegsstenose l " Revision Key words l " endonasal dacryocystorhinostomy l " transillumination l " tear duct obstruction l " revision eingereicht 3. 4 [1] und stellt somit im erschwerten Operationsfeld, wie zum Beispiel bei Revisionsdakryozystorhinostomien, eine wesentliche Hilfestellung für den Operateur dar. Die endonasale DZR wird neben der externen DZR angewandt.…”

“…Dieses Verfahren wird von vielen anderen Operateuren ebenfalls angewendet. Die Verweildauer des Schlauchs variiert von 4 Wochen bis zu 12 Monaten[1,17]. Viele Autoren sehen die Silikonschlauchintubation als wesentlichen Grund für ihren Operationserfolg[18,19].…”