By Livio Presutti, Francesco Mattioli
This guide covers all elements of endoscopic surgical procedure of the lacrimal drainage process. step by step descriptions are supplied of endoscopic dacryocystorhinostomy (DCR) and its use in revision surgical procedure, observed through quite a few invaluable pictures and anatomical drawings. additionally, transparent movement charts are incorporated to help in diagnostic and surgical selection making and establish surgical symptoms. crucial details is supplied on anatomy, body structure and pathology and someone bankruptcy is dedicated to imaging of the lacrimal drainage process. additional themes comprise lacrimal probes and stents, capability issues of surgical procedure, and endoscopic DCR within the pediatric age crew. This publication will help the practitioner in negotiating the steep studying curve all for gaining the abilities had to practice endoscopic surgical procedure of the lacrimal drainage method, which bargains major benefits when it comes to avoidance of exterior incisions and upkeep of the lacrimal pump.
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Additional resources for Endoscopic Surgery of the Lacrimal Drainage System
Sample text
Ophthalmol Clin North Am 9:229–237 5. Pediatric Eye Disease Investigator Group (2012) Resolution of congenital nasolacrimal duct obstruction with nonsurgical management. Arch Ophthalmol 130:730–734 6. Schnall BM (2013) Pediatric nasolacrimal duct obstruction. Curr Opin Ophthalmol 24(5):421–424 7. Kushner BJ (1982) Congenital nasolacrimal system obstruction. Arch Ophthalmol 100:597–600 8. Kashkouli MB, Kassaee A, Tabatabaee Z (2002) Initial nasolacrimal duct probing in children under age 5: cure rate and factors affecting success.
The treatment is to open or enlarge the punctum with a mechanic dilatation and a punctoplasty performed by a posterior ampullotomy. Moreover, a functional stenosis of the lacrimal punctum is possible. In this case, the punctum is wide open but not functioning or malfunctioning. It happens, for example, in case of anomalous position of the lacrimal punctum, primary or secondary to lid anomaly, or in case of abundant conjunctival tissue that closes the punctum. 3 Acquired Canalicular Stenosis Canalicular obstruction could be partial or total and could affect one or both canaliculi or the common canalicular duct.
Failed probings usually occur within 6 weeks of the procedure and are marked by the return of crusting and tearing. The success rate for various procedures after a single failed probing was 56 % for repeat probing, 77 % with balloon catheter dilation, and 84 % with nasolacrimal duct intubation [14, 15]. Both balloon catheter dilation and nasolacrimal duct intubation would be good options after a failed probing. In case of repeated failures, generally due to bone anomalies at the end of the NLD, a DCR is suggested, after 4 years of age.