Dacriocistorrinostomia endoscópica transnasal

Abstract

During long time, the lacrimal pathway has been studied and treated by two special-ties. Otolaryngology and ophthalmology. As time has gone by, different techniques for treating the lacrimal pathway have been developed, such as the traditional ex-ternal approach and the laser assisted procedures. Nowadays, endoscopic DCR (dacryocystorhinostomy) is the ideal procedure for treating the lacrimal pathway insufficiency and stenosis secondary to trauma, dacryocystitis or dysfunction of the nasolacrimal pathway. We report our experience in the management of these di-sorders with the Ecopetrol Hospital in Barrancabermeja’s Ophthalmology service, giving special relevance to the surgical technique and the postoperative results avoi-ding the morbidity of the external dacryocystorhinostomy. Es importante identificar claramente la inserción del cornete medio en la pared lateral. Se confecciona entonces un colgajo de la mucosa con base posterior de aproximada-mente 1cm, (Figura 2) por delante de la axila del cornete medio para exponer el plano óseo, realizando osteotomía de la apófisis frontal del maxilar a nivel del hueso lagrimal. Es pertinente asegurar en éste paso la hemostasia para tener una visión clara y controlar el nivel del corte.Figura 1. Identificación de la línea maxilar.Figura 2. Colgajo mucoso anterior a la axila del cornete medio.