[Endoscopy of the nose as an aid in lacrimal duct surgery]. / Endoskopie der Nase als Hilfe für die Tränenwegschirurgie.

ABSTRACT

Endoscopy of the nose is a recently-adopted supplementary procedure for examining the tear drainage system. This examination is performed under local anesthesia with the patient on the operating table. We use a Hopkins endoscope with 30 degrees and 70 degrees deflections, diameter 2.7 mm and 4 mm. Endoscopy prior to dacryocystorhinostomy enables the examiner to judge whether the nasal cavity is large enough for an osteotomy. The orifice of the nasolacrimal duct is visible directly through the endoscope, so that the dye test can be rendered fairly objective. Endoscopy also enables the course of healing of the nasal ostium after surgery to be studied. We observed complications, such as granular tissue and synechiae developing between the posterior flap of the nasal mucosa, the middle turbinate and the nasal septum. Granulation tissue may be removed under endoscopic control. If an intubation of the lacrimal system is attempted, it may be easier to find the end of the steel probe exiting into the nose under endoscopic observation. If the inferior turbinate is impacted with the nasal floor, it may be impossible to find the probe under the inferior turbinate without endoscopic control. Finally, during lacrimal duct probing in infants, one can check whether the probe is correctly sited. Perforations created by probing can be recognized and avoided.