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 threading is suitable for: 1. The tubules are blocked. 2. Total tear tubule obstruction. Contraindications The lacrimal sac has acute inflammation. Preoperative preparation The conjunctival sac was thoroughly rinsed with saline, and the ephedrine and tetracaine cotton sheets were placed in the lower nasal passage and the inferior turbinate, and the surface mucosa was anesthetized and the lower nasal passage was widened. Punctum dilator, No. 0 lacrimal probe, with a small hole at one end, wearing 3-0 silk thread, sniffer nose, nose and frontal mirror, with plastic tube - take medical plastic tube with outer diameter 1mm, inner diameter 0.8mm It is about 20cm long and wears a 5-0 silk thread inside. One end of the thread is made thick, and the other end is taken out about 10cm. After the middle part of the tube is heated, the two ends are pulled to make the middle section thinner, the thick knot of the thread is fixed at the thinning of the plastic tube, and the plastic tube is cut off from the central part, but the thread is not damaged, and the hook is pulled. Surgical procedure 1. Take the sitting position, push the lower jaw to the outside with your finger, fix it to the outer edge of the armpit, make the lacrimal canal straighten tightly, insert the punctum dilator vertically into the punctum, and then turn horizontally to the nose. On the side, rotate slightly in the horizontal direction to enlarge the punctum. 2. According to the method of exploring the lacrimal passage, the probe with the thread is inserted into the lacrimal canal from the lower punctum, passes through the obstruction and enters the lacrimal sac, and after hitting the bone wall, the probe is lightly pressed against the bone wall as a fulcrum, and the needle tail is For 90° steering, the rotating needle should be close to the forehead. Do not lift it. Finally, push the probe slightly backwards into the nasolacrimal duct and straight to the nasal cavity. 3. The patient's lower jaw is attached to the chest wall, and the probe tip and the frontoscope are used to observe the tip end of the probe. The silk thread is visible on both sides of the probe head. 4. Hook the wire loop with the cable hook and gradually withdraw the probe and pull the wire loop out of the nose. 5. Place the plastic wire into the wire loop outside the nose. At the same time as the probe is pulled out, the plastic tube will then pull out the punctum in the reverse direction. When the plastic pipe thread is pulled until it can no longer be pulled out, the wire is integrated small. The group is fixed in the lower jaw and near the inner part. The plastic tube exposed outside the nose is cut short to expose the nose 3 to 5 mm, and finally hidden in the nasal vestibule.