lacrimal canalicular dacryocystorhinostomy

The lacrimal canal is occluded and the nasal cavity is normal, but the lacrimal sac has been proven to be intact, and the nasolacrimal duct has been occluded. Treatment of diseases: lacrimal passage obstruction Indication The lacrimal canal is occluded and the nasal cavity is normal, but the lacrimal sac has been proven to be intact, and the nasolacrimal duct has been occluded. Preoperative preparation 1. Surface anesthesia of the punctum: deep infiltration anesthesia in the lacrimal sac area, the top of the lacrimal sac and the upper part of the nasolacrimal duct, and the same as the lacrimal sac removal. The front end of the middle and middle turbinate was filled with cotton pad with 1% dicaine and 0.5% ephedrine for 10 minutes. 2. Prepare a 14 cm long epidural catheter. Surgical procedure 1. Cut the skin according to the dacryocystorhinostomy method, and after separating the muscles, make two incision positions on the tear fascia. 2. First, make a sacral incision, and cut the iliac crest to expose the obstruction of the common tear duct. Cut off the obstruction. The lacrimal duct probe was inserted from the lateral hole of the lacrimal sac and the nasolacrimal duct was explored. 3. If the nasolacrimal duct is unobstructed, only the lacrimal canal anastomosis can be performed. If the nasolacrimal duct is obstructed, it is carried out in accordance with this Law. 4. First for the lacrimal canal anastomosis (refer to the procedure, but not sutured). The periosteum, the bone making hole, the lacrimal sac and the nasal mucosa flap were separated according to the dacryocystorhinostomy. The small round hole left after the tear duct was cut out was seen on the side wall of the lacrimal sac. 5. Stitch the lacrimal sac and the posterior flap of the nasal mucosa, the round hole of the lacrimal sac and the lower and lower corners of the tear duct. 6. Use an epidural catheter to insert from the small punctum, introduce the lacrimal sac through the small round hole, and send it into the nasal cavity. Pull a small amount of nasal gauze into the lacrimal sac. 7. Use the 5-0 silk thread or nylon thread to suture the anterior horn of the lacrimal sac and the nasal mucosa anterior flap, the lacrimal sac and the tear duct. 8. Using a 3-0 nylon thread, suture the internal hemorrhoids with a u-shaped suture, suture the periosteum and the rest of the tear fascia. 9. Suture the muscles and skin according to the dacryocystorhinostomy. Single dress bandage, single eye light pressure bandage. The epidural catheter with a small tear is exposed and applied to the skin of the eyebrow with a tape. complication The main complication was re-occlusion, which was considered based on the re-occlusion site.

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