Subciliary endonasal DCR
by Prakash V Dhond, Prakash Rajesh Yadav, Prakash Girish Surlikar

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

by Vicky S Khattar, Bachi T Hathiram
About Video

This is a surgical technique that combines the principles of both the endoscopic as well as external DCR procedures in the authors’ experience. The advantages include a large osteotomy defect, the ability to suture the sac walls to the mucosa under direct vision with the advantage of allowing healing by primary intention, as well as the prevention of a postoperative ‘sump’ effect by making the opening into the sac at the level where it leads to the nasolacrimal duct. The osteotomies are also performed at the same lower level to allow for easy access. Also, while this surgical technique simulates an external DCR, it does not leave an external scar, besides avoiding injury to the medial canthal ligament and angular vein, which can be possible with an external DCR procedure. At the same time, it allows for easier suturing of the sac walls to the nasal mucosa as compared to endoscopic techniques, thus ensuring a favorable outcome. Thus, in the authors’ experience, although it simulates endoscopic as well as external DCR procedures in many ways, it combines their advantages as well.

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