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Endoscopic repair of failed dacryocystorhinostomy.

Authors
  • Orcutt, J C
  • Hillel, A
  • Weymuller, E A Jr
Type
Published Article
Journal
Ophthalmic Plastic and Reconstructive Surgery
Publisher
Ovid Technologies (Wolters Kluwer) - Lippincott Williams & Wilkins
Publication Date
Jan 01, 1990
Volume
6
Issue
3
Pages
197–202
Identifiers
PMID: 2268614
Source
Medline
License
Unknown

Abstract

Primary dacryocystorhinostomy (DCR) failure is commonly due to scarring at the rhinostomy site. Nasolacrimal duct obstruction due to scarring may also occur in patients who have had their lacrimal bone removed during maxillary sinus surgery. Five patients following DCR and 3 patients after sinus surgery, all with constant epiphora, underwent endoscopic reconstruction of their lacrimal drainage system. Preoperatively, patency of the bony ostium was determined either by computed tomographic (CT) scan or dacryocystography. Endoscopically, the lacrimal drainage system was reopened then intubated with a silastic stent. Any scar tissue was visualized endoscopically and resected. Seven of the 8 patients have been followed from 3 to 24 months after stent removal, and all have had relief of their epiphora. Endoscopic repair is a useful adjunct in the management of patients with DCR failure or patients with epiphora after removal of the lacrimal bone during sinus surgery. This brief procedure can be performed under local anesthesia, does not require a skin incision, and allows the evaluation and correction of intranasal pathology.

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