7/30/2023 0 Comments Endo surgery meaningDirect suturing of the nasolacrimal sac and lateral nasal mucosal flaps allow for optimal apposition and primary intention healing of the flaps to create the bypass system.ĭisadvantages include a visible scar compared to the internal approach. A large osteotomy is created with direct visualization of lacrimal sac abnormalities, such as lacrimal stones, foreign bodies, or tumors. Primary external dacryocystorhinostomy-Īdvantages of the external approach include excellent success rates, reported to be up to 90-95%.Congenital NLDO after failed prior probing or intubation.Functional obstruction of outflow, due to lacrimal pump weakness or after facial nerve palsy.Secondary acquired NLDO, such as due to prior midfacial trauma, chronic nasal or sinus inflammation, nasal surgery, neoplasms, dacryoliths.Partial NLDO in adults may occasionally be amenable to silicone intubation without DCR or balloon-assisted dacryoplasty. Initial treatment of NLDO includes determining and addressing the cause(s) of tearing, and correcting any eyelid malposition or ocular surface abnormalities contributing to symptoms. The disadvantages of DSG include the low resolution and lack of anatomic detail. The canaliculi and sac should be visualized within 10-12 seconds following injection, with passage into the nasal cavity occurring within 10-30 minutes. The patient is seated and immediately imaged using a gamma camera to take rapid pictures of the lacrimal outflow system as the tracer flows passively through the lacrimal pump system.
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