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Dacryocystorhinostomy
Endoscopic Dacryocystorhinostomy (right nasal cavity).
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| 1.Mucosal incisions at the region of the lacrimal sac. | 2. Elevation of the mucosal flap. |
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| 3. Removal of the soft lacrimal bone with a Freer elevator. | 4. Removal of the hard bone of the frontal process with a Hajek punch. |
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| 5. Continuing the revealing of the lacrimal sac with the punch. | 6. Removal of the anterior wall of the agger nasi cell and opening of the mucosa. |
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| 7. Completion of the uncovering of the lacrimal sac with a diamond burr. | 8. Opening the lacrimal sac after probing the inferior punctum. |
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| 9. Creation of a large anterior flap and … | 10. ...a small posterior flap to approximate the mucosa of the agger nasi cell. |
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| 11. Grasping the probe with a forceps and removing from the nasal cavity. | 12. Dilatation of the superior punctum and insertion of the other end of the probe. |
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| 13. A silastic tube is slid over the lacrimal tubes. | 14. Checking the loop in the medial canthus. |
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| 15. Securing the tube with clips. | 16. Trimming the original mucosal flap to secure the flaps of the lacrimal sac. |
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| 17. The final shape of the mucosal flap. | 18. Placing the limbs of the mucosal flap around the silastic tube. |
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| 19. Securing the flaps with absorbable material. |
