|Year : 1966 | Volume
| Issue : 4 | Page : 176-177
One flap dacrocystorhinostomy
VN Prasad, SP Bajpeyi
Department of Ophthalmology, G.S.V.M. Medical College, Kanpur, India
|Date of Web Publication||17-Jan-2008|
V N Prasad
Department of Ophthalmology, G.S.V.M. Medical College, Kanpur
Source of Support: None, Conflict of Interest: None
|How to cite this article:|
Prasad V N, Bajpeyi S P. One flap dacrocystorhinostomy. Indian J Ophthalmol 1966;14:176-7
We present here an easy method of doing a Dacryocystorhinostomy which has been done in forty cases at G.S. V.M. Medical College, Kanpur, in the out-patients department.
| Operative technique|| |
A nasal examination is done in all cases to exclude any pathological contraindication. Patients 15 yrs. of age or more are chosen for the operation and are given local anasthesia. The nose is packed with a solution of 10% Cocaine with adrenaline and Zylocaine is injected locally. Streptochrome is given to all patients to reduce bleeding.
Operation: The lacrimal sac and fossa are exposed by the usual incision and dissection.
The anterior lacrymal crest is removed and adequate bone from lacrymal fossa is removed by Citelli's punch forceps upto the naso lacrymal duct. The opening must be 15 x 12 mm big with rounded edges.
Now an incision is made in the sac on the medial side extending from the naso lacrymal duct to the upper limit of the fundus and then extending the the two limits of the incision anteriorly. Thus one big anterior flap is formed. In the same way a big anterior flap is prepared in the nasal mucosa by giving an incision along the posterior border of the bony opening and extending its limits anteriorly.
The two anterior flaps are stitched with 6.0 silk thread. Then the sac is syringed by a solution of crystalline penicillin and the wound is closed. An antibiotic ointment and dressings are applied. The patient comes every third or fourth day for syringing for 2 weeks. The stitches are removed on the 7th day.
| Observations|| |
All the cases selected were 15 years of age or more. After operation we have evaluated the patency by syringing. [Table - 1]. In 72.5 patency was achieved within three syringings while in 20% more than three syringings were required. So a total success of 92.5% patency was achieved by this procedure. Although in 3 cases epiphora was not relieved [Table - 1] and [Table - 2] in no case there was regurgitation of purulent matter on pressing the sac.
| Discussion|| |
This operation is so simple and so little time consuming that it can be done as an outdoor operation. In younger age groups a general anasthesia may be required. There are no inconvenient posterior flaps to stitch and the large anterior flaps prepared can be stitched easily.
If the flaps are too big. they must be anchored on the surrounding tissue as they may sag and block the newly made passage.
| Summary|| |
Forty cases of Dacryocystorhinostomy with stitching of anterior flaps of lacrymal sac and nasal mucosa were performed. This procedure can be adopted as an out-patient procedure. The success of this technique was 92.5 in this series.
[Table - 1], [Table - 2]