Endonasal Dacrocystorhionostomy – How to Find the Lacrimal Sac
Komínek P.1, Červenka S.1,2, Matoušek P.1
ORL klinika Fakultní nemocnice Ostrava, přednosta doc. MUDr. P. Komínek, Ph.D., MBA1 Oční ambulance Otrokovice2 |
|
Summary:
The retrieval of lacrimal sac is the most difficult task in endonasal dacryocystorhinostomy and conjunctivocystoirhinostomy.
The structure serving as the basic landmark of orientation is the insertion of medium
nasal concha on lateral nasal wall. The sac is usually found at the location of concha insertion or
immediately before it at the level of linea maxillaries.
In addition to the anatomical-topographic knowledge, the lacrimal sac can be localized by other methods,
e.g. by translumination of the lacrimal sac. The fastest and simplest method, used also by the authors, is
the localization of the sac by means of bayonet pincers – one branch localized in the area of ocular corner,
the intranasal branch then points to the site of lacrimal sac projection. It is the way of simple estimate
the need of rescting thre head of middle concha or opening of the frontal olfactory air sacs. The significant
advantage of the method is in that it can be repeated during the surgery even in a disorganized
or untransparent and bleeding terrain.
Key words:
dacryocystorhiostomy, conjunctivocystorhinostomy, sac localization, bayonet pincers
|