RESUMEN
Chronic dacryocystitis is due to an obstruction in the nasolacrimal duct, with subsequent infection of the lacrimal sac. The goal of surgery is to reestablish intranasal drainage of the lacrimal sac. Classic dacryocystorhinostomy (DCR) requires an external incision and drilling through the lacrimal bone into the middle meatus. In our study a 600-micron neodymium:YAG (Nd:YAG) fiber with a blunt hemispherical tip is inserted via the lacrimal puncta. An intranasal ostium is created with the laser under intranasal endoscopic control. Silicon tubes are then left in place for 6 months. We have performed 49 procedures over the past 2 1/2 years, with a success rate of 85% after one surgical procedure, which is commensurate with standard DCR. This procedure provides a simple, bloodless, incisionless alternative to standard DCR.
Asunto(s)
Dacriocistitis/cirugía , Dacriocistorrinostomía/métodos , Enfermedades del Aparato Lagrimal/cirugía , Terapia por Láser , Enfermedad Crónica , Endoscopía/métodos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Resultado del TratamientoRESUMEN
A resistively heated scalpel (Shaw scalpel) was used in ten patients for orbital and lid surgical procedures. The blade temperature is set from 110 degrees to 270 degrees C producing a remarkable hemostatic effect with minimal thermal damage to the incision margins. The instrument has proven useful in preserving a good view of the anatomy during dissection and specifically it simplifies excision of orbital fat in blepharoplasty and orbital decompressions for Graves' orbitopathy. Significant shortening of surgical procedures was appreciated in all cases.