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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. |