Principles of Surgical Technique in DCR

Many different ways of creating a rhinostomy have been described, but the main objectives are:

1 To create a rhinostomy from the sac through the lateral nasal wall.

2 To create a rhinostomy that is about 5 mm wide (Figure 14.16a, b).

3 To minimize trauma to the lacrimal system and sac.

4 To minimize damage to the mucosa around the rhi-nostomy site.

5 To avoid a high rhinostomy, as this can produce a sump syndrome.

6 To avoid collateral mucosal damage in the nose, to minimize the formation of adhesions.

Adhesions Nasal Cavity Post Dcr
Fig. 14.15 Looped stents that pass through each cannaliculus and are fed over a Watskie sleeve before being tied.

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