[Fiber optic endoscopically-guided intranasal dacryocystorhinostomy in post-traumatic surgery of the lacrimal ducts]

Increasingly today, dacryocystorhinostomy seems to be the common obligatory path to functional surgery in case of traumatic lesions of the lacrimal ducts. The endonasal approach provides direct access to the nasolacrimal canal, while permitting to avoid the cutaneous approach through tissues that may be coming apart. The use of optic endoscopes renders the operation easier and provides access to the dome of the lacrimal sac, which is impossible under conventional endonasal microscopy. Monitoring and postoperative care are carried out with the same instrument, thereby improving the quality of the end result. The operation usually takes place under potentiated local anesthesia and lasts one hour, on average. The various surgical steps are described and particular attention is given to endonasal localization of the lacrimal ducts and to the technique of marsupialization.