By Livio Presutti, Francesco Mattioli
This guide covers all features of endoscopic surgical procedure of the lacrimal drainage procedure. step by step descriptions are supplied of endoscopic dacryocystorhinostomy (DCR) and its use in revision surgical procedure, observed by means of various useful photos and anatomical drawings. additionally, transparent circulate charts are integrated to assist in diagnostic and surgical choice making and determine surgical symptoms. crucial details is supplied on anatomy, body structure and pathology and someone bankruptcy is dedicated to imaging of the lacrimal drainage method. extra issues contain lacrimal probes and stents, strength problems of surgical procedure, and endoscopic DCR within the pediatric age workforce. This publication will support the practitioner in negotiating the steep studying curve excited about gaining the talents had to practice endoscopic surgical procedure of the lacrimal drainage process, which bargains major merits by way of avoidance of exterior incisions and upkeep of the lacrimal pump.
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Additional resources for Endoscopic Surgery of the Lacrimal Drainage System
Patient with canaliculitis typically presents with some combination of epiphora, unilateral conjunctivitis, punctal discharge with concretions, and canalicular swelling. Colla and associates  found in their series of 32 patients that a membranous stenosis at the internal punctum was the most common type of common canalicular stenosis. Canalicular obstruction is generally incidental to inflammations; marginal lid or corneoconjunctival infections (mainly herpetic and actinomyces); trauma after imprecise attempts of probing or washing or recurrent therapies with antiviral (idoxuridine) or antiglaucoma (epinephrine) drops or hypotonic drugs; systemic administration of toxic drugs as fluorouracil or docetaxel; thermic or ionizing radiations; tumors; idiopathic, chronic dacryocystitis; Chlamydia infection (trachoma); scarring diseases as ocular pemphigoid or Stevens–Johnson disease ; or lichen planus .
Arora S, Koushan K, Harvey J (2012) Success rates of primary probing for congenital nasolacrimal obstruction in children. J AAPOS 16:173–176 12. Honavar SG, Prakash VE, Rao GN (2000) Outcome of probing for congenital nasolacrimal duct obstruction in older children. Am J Ophthalmol 13:42–48 13. Andalib D, Gharabaghi D, Nabai R, Abbaszadeh M (2010) Monocanalicular versus bicanalicular silicone intubation for congenital nasolacrimal duct obstruction. J AAPOS 14:421–424 14. Pediatric Eye Disease Investigator Group (2009) Repeat probing for treatment of persistent nasolacrimal duct obstruction.
5). DCG plays a primary role, enhanced by the possibility to combine the diagnostic time with a therapeutic interventional procedure (see below), ultimately offering one-stop-shop management. Secondary NLD obstruction may be due to noninfectious inflammatory diseases, chemotherapy, cocaine abuse, foreign bodies (dacryoliths), or trauma  (Fig. 6). a b c c d e Fig. 5 DCG (a) shows partial obstruction of the right NLD (arrowheads) and lacrimal sac dilatation (arrows). On MRI, the lacrimal sac shows T2 hyperintensity (b) and T1 hypointensity (c), compatible with fluid content.
Endoscopic Surgery of the Lacrimal Drainage System by Livio Presutti, Francesco Mattioli