Endoscopic dacryocystorhinostomy (DCR)
by Vicky S Khattar, Vicky Bachi T

Jaypee’s Video Atlas of Operative Otorhinolaryngology AND Head & Neck Surgery

by Vicky S Khattar, Bachi T Hathiram
About Video

This video demonstrates the technique of endoscopic DCR in a stepwise manner. A good exposure of the lacrimal sac is vital to ensure a successful outcome. After infiltrating the lateral nasal wall anterior to the middle turbinate, an incision is taken and the musocperiosteal flap is elevated. The lacrimal bone and part of the ascending process of the maxilla is removed so as to expose the lacrimal sac. The sac is cannulated from the punctum exteriorly, tented, incised to evacuate the contents and marsupialized. The wall of the sac may be removed, or even sutured to the flap as demonstrated at the end of the procedure to prevent a closure of the nasal opening. At the end of the procedure, a free flow of saline or diluted tryphan blue should be visible endoscopically. Also, one should be able to visualize the opening of the common canaliculus through the marsupialized sac endoscopically.

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