Endoscopic Dacryocystorhinostomy - 22/08/11
Doi : 10.1016/B978-0-323-05283-2.00056-2
Key Points |
• | Chronic epiphora should be investigated with a dacryocystogram and possibly a scintillogram prior to surgery to localize the site of obstruction to ensure that it is amenable to dacryocystorhinostomy. |
• | Although anatomic obstructions of the lacrimal system are associated with excellent surgical outcomes, functional obstructions have less impressive responses to surgery. It is important to differentiate between these two types of obstruction to determine a patient’s prognosis. |
• | The superior edge of the lacrimal sac is located well above the insertion of the middle turbinate. Surgical outcomes are improved when the entire sac is marsupialized. |
• | The primary surgical goal is to lay the marsupialized lacrimal sac flat without tension in direct contact with surrounding mucosa for primary intention healing. This concept allows outcomes of endonasal dacryocystorhinostomy to equal those of the external procedure. |
• | Advantages of endonasal over external dacryocystorhinostomy include the lack of an incision and no disruption of the lacrimal pump mechanism. |
E. Weitzel has no financial interest/arrangement or affiliation with one or more organizations that could be perceived as a real or apparent conflict of interest in the subject of this paper. P-J. Wormald has a financial interest/arrangement with Medtronic Xomed for royalties received from design of surgical instruments.
Plan
© 2010 Elsevier Inc. Tous droits réservés.© 2008 (© 2008 by Johns Hopkins University, Art as Applied to Medicine.). Publié par Elsevier Masson SAS. Tous droits réservés.© 2008 (© 2008 by Johns Hopkins University, Art as Applied to Medicine.). Publié par Elsevier Masson SAS. Tous droits réservés.© 2008 (© 2008 by Johns Hopkins University, Art as Applied to Medicine.). Publié par Elsevier Masson SAS. Tous droits réservés.© 2008 (© 2008 by Johns Hopkins University, Art as Applied to Medicine.). Publié par Elsevier Masson SAS. Tous droits réservés.© 2008 (© 2008 by Johns Hopkins University, Art as Applied to Medicine.). Publié par Elsevier Masson SAS. Tous droits réservés.© 2008 (© 2008 by Johns Hopkins University, Art as Applied to Medicine.). Publié par Elsevier Masson SAS. Tous droits réservés.© 2008 (© 2008 by Johns Hopkins University, Art as Applied to Medicine.). Publié par Elsevier Masson SAS. Tous droits réservés.
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