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Endoscopic Dacryocystorhinostomy

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Tears are produced in the outer corner of the eye, they wet the eye, they end up /result into the lacrimal sac and then are drained into the nose through the nasolacrimal duct.

For some patients, repeated inflammation may produce adhesions and stenosis within the lacrimal sac and the tear duct so that the tears stagnate in the eye causing excessive lacrimation (epiphora). Moreover, some of these infections can cause cellulitis of the skin area or develop fistula with purulent flow. The patient visits the ophthalmologist, who will try to deal with the problem, at first in a conservative way. If, despite the improvement of the inflammation, the difficulty in the drainage of tears remains, then the patient is referred for more radical, surgical therapy. The ophthalmologist will carry out all the diagnostic tests required in order to determine and support that the problem lies in the lacrimal sac and the nasolacrimal duct and then he/she will refer to the otolaryngologist, to jointly plan the surgery. Until recently, the surgery was performed through an external approach through a small incision between the eye and nose.

Today, the endoscopic surgery of the nose, gives us the opportunity to perform the operation through the nose without performing external incision, and achieving the same high success rate. Before surgery, the otolaryngologist will examine the patient to determine the ease of accessing the area where the surgery will be done. So, if a septal deviation is found, then, even locally, the straightening of the septum should precede the main part of the surgery and should be counted in the total surgical time. In addition, the doctor will have the opportunity to explain to the patient the rational of access and, generally, the way surgery will be performed.

The procedure is performed preferably under general anesthesia and lasts between one and one and a half hour. An important part of the operation is the complete endonasal uncovering of the lacrimal sac by using the proper guiding points. At the end of surgery, a small tube is placed from the eye to the nose in order to ensure the success of the opening of the sac. The tube does not cause any discomfort to the patient and it is removed after 4 to 6 weeks. No nose tamponade is necessary. The patient is discharged the next day after being given the necessary instructions. His / her postoperative course is painless and without any major discomfort.