Retrocaruncular approach to the medial orbit for dacryocystorhinostomy

Abstract

DCR may be safely completed through a retro-caruncular approach. The retrocaruncular approach provides excellent and safe exposure of the posterior aspect of the lacrimal sac, and it avoids the scarring associated with the skin approach.

Transconjunctival approach in orbital traumatology: A review of 56 cases

“…The transconjunctival approach gives a wide view of the orbital floor and of the inferior orbital border similar to the palpebral approach, but without secondary scarring (Jackson et al, 1987;Mullins et al, 1997;Raffaini et al, 2002;Adenis and Robert, 2003;Ridgway et al, 2009).…”

“…Some authors suggest that the transconjunctival approach is more difficult than the palpebral approach, with a longer learning curve and is more time consuming (Waite and Carr, 1991;Mullins et al, 1997;Adenis and Robert, 2003).…”

Aesthetic assessment in periciliary “v-incision” versus conventional external dacryocystorhinostomy in Asians

“…Retrocaruncular and transconjunctival approaches have been described to avoid any cutaneous scar in external DCR [14][15][16]. Conversion to an external approach was necessary when orbital fat prolapsed into the lacrimal fossa, causing visualization and manipulation of bony and soft tissues to be difficult.…”

“…For these reasons, external DCR is still being performed frequently. Conventionally, external DCR is performed by vertically incising the lateral nasal wall, and modified techniques of external DCR such as J-shaped, W-shaped, and subciliary incisions have been described either to minimize scar formation [5][6][7][8][9][10][11][12][13] or even to avoid a cutaneous scar through retrocaruncular and transconjunctival approaches [14][15][16][17]. Periciliary incisions near the skin-mucosal junction at the lacrimal portion of the lid margin is performed during V-Y epicanthoplasty to avoid noticeable scar formation in Asians [18][19][20].…”

Polyurethane stents for lacrimal duct stenoses: 5-year results

“…The therapeutic options for postsaccal lacrimal duct stenoses include silicone tube intubation, dacryocystorhinostomy via transcutaneous (Toti procedure), endonasal or retrocaruncular [1] approach, balloon dacryoplasty [4,18], endoscopic laser dacryoplasty [5] and polyurethane stent implantation. Polyurethane stents were introduced in 1995 by Song [22][23][24][25].…”