lacrimal cannulation

Because of the complicated operation of lacrimal canal anastomosis and dacryocystorhinostomy, sometimes according to the specific conditions, the simpler cannula or intubation can be used to treat the lacrimal canal or total lacrimal duct obstruction. , silicone tube, silicone strip method for the treatment of chronic dacryocystitis nasolacrimal duct obstruction. Although the curative effect of this type of surgery is inferior to the method of anastomosis, the operation is simple and time-saving, and the patient suffers little pain. If the operation fails, the anastomosis or other surgery is not affected. However, it must be emphasized that the operator must be familiar with the anatomical features of the lacrimal duct and its surrounding tissues. The operation must be stable and light, otherwise it will damage the normal lacrimal tissue, form too many scars or cause false roads, not only fail to meet expectations. The purpose will also bring new difficulties to the reoperation. Treatment of diseases: chronic dacryocystitis Indication Lacrimal duct intubation is applicable to: 1. The tubules are blocked. 2. Total tear tubule obstruction. 3. The nasolacrimal duct is blocked. Contraindications The lacrimal sac has acute inflammation. Preoperative preparation 1. Rinse the conjunctival sac with saline. The eczema and tetracaine cotton sheets were placed in the lower nasal passages and the inferior turbinate, and the inferior turbinate was anesthetized and the lower nasal anesthesia was widened. 2. If there is secretion in the lacrimal sac, rinse the lacrimal sac with saline. 3. Punctum dilator, lacrimal probe (0 to 4), acupuncture needle, peoscope, forehead, and tube hook. 4. Plastic tube - take a plastic plastic tube with an outer diameter of 1mm and an inner diameter of 0.8mm, which is about 20cm long. After heating at both ends and middle sections of the tube, gently pull it to make the diameter of the tube gradually thinner. The tapered part of the middle section is about 25mm long, and the bend is semi-annular. The ends of the tapered ends are cut, and the needles are pierced into the lumen from the tube wall, so that the needle tip is flush with the tube end, just outside the tube. The tube core and the support are used for intubation. Surgical procedure 1. The patient's position, eyelid fixation, punctum enlargement and exploration of the lacrimal passage are the same as the lacrimal duct intubation. 2. During the exploration of the lacrimal passage, the lacrimal probe is gradually changed from a fine needle to a thicker probe to expand the lacrimal passage, and the probe is switched from No. 0 to 1, 2, and 3, etc., depending on the specific circumstances, so that After the blockage is detected, it gradually expands. 3. Hold the plastic tube, and insert the end of the tube into the lower nasal passage by the lower punctum, the lacrimal canal, the lacrimal sac, and the nasolacrimal duct according to the method of exploring the lacrimal passage. 4. The patient's lower jaw is close to the chest wall. After seeing the plastic tube with the sniffer and the frontal mirror, pull the plastic tube out with a hook, and pull out the needle inserted into the plastic tube to pull the plastic tube out of the nose. outer. 5. The other end of the plastic tube is inserted into the lower nasal passage from the upper lacrimal point, the upper lacrimal duct, the lacrimal sac, and the nasolacrimal duct, and the nose is taken out. 6. The half ring of the plastic tube is located between the upper and lower punctum, the thin part is located in the upper and lower tear duct and the total tear duct, and the undrawn part is the double tube located in the lacrimal sac and the nasolacrimal duct, and the two ends of the tube simultaneously lead out the nose. They can be cut 3 to 5 mm outside the nose and hidden in the nasal vestibule.