Dacryocystorhinostomy
Encyclopedia
Dacryocystorhinostomy is a surgical procedure to restore the flow of tears into the nose from the lacrimal sac
when the nasolacrimal duct
does not function.
With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. The bone covering the lacrimal sac is nibbled out. The medial wall of the sac is excised, facilitating drainage of tears into the nasal cavity. This procedure avoids scarring.
Lacrimal sac
The lacrimal sac is the upper dilated end of the nasolacrimal duct, and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla...
when the nasolacrimal duct
Nasolacrimal duct
The nasolacrimal duct carries tears from the lacrimal sac into the nasal cavity. Excess tears flow through nasolacrimal duct which drains into the inferior nasal meatus...
does not function.
Traditional
A small incision is made on the side of the nose and some bone is removed to make a connection to the nose. Drains are left behind to prevent the gap from closing and are removed after a few months. A Jones or Crawford Tube is placed to facilitate the flow of tears from the eye to the nose.Endoscopic
The operation can also be performed endoscopically through the nose where an opening is fashioned in the lacrimal sac from within the nose. Newer techniques and advances in endoscopic surgery have increasingly made this approach the procedure of choice. The advantages include lesser peri-operative morbidity, no scar and a high success rate. Even revision surgery done by the endoscopic route is easier.With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. The bone covering the lacrimal sac is nibbled out. The medial wall of the sac is excised, facilitating drainage of tears into the nasal cavity. This procedure avoids scarring.