In this article the scientist and researchers have broaden the use of laser with the aid of digital microscopes for dacrocystorhinostomy. They have compared the results between conventional external dacrocystorhinostomy or ext DCR and endonasal laser-assisted DCR or ELADCR. Dacrocystorhinostomy is a surgical procedure used now days to restore the flow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function. A tiny incision is made on the side of the nose and some bone is removed to make a connection to the nose. The lacrimal sac, is said to be the upper dilated end of the nasolacrimal duct, and is lodged in a deep groove formed by the lacrimal bone and frontal process of the maxilla. And for the nasolacrimal duct carries tears from the lacrimal sac into the nasal cavity. Excess tears flow through nasolacrimal duct, which opens in the nose. This is the reason the nose starts to run when a person is crying. Obstruction of the nasolacrimal duct leads to the excess overflow of tears called epiphora. Drains are left behind to prevent the gap from closing and are removed after a few months.
The process can also be performed endoscopically through the nose where an opening is fashioned in the lacrimal sac from within the nose. Newer techniques and advances in endoscopic surgery have increasingly made this approach the procedure of choice. The advantages include lesser peri-operative morbidity, no scar and a high success rate. Even revision surgery done by the endoscopic route is easier. Endoscopic dacrocystorhinostomy is stated that with the advent of nasal endoscopes endoscopic dacrocystorhinostomy is becoming so much popular. In this procedure a nasal endoscope is used to visualize the lacrimal sac through the nasal cavity.
The bone covering the lacrimal sac is nibbled out. The medial wall of the sac is excised facilitating drainage of tears into the nasal cavity. This procedure avoids scar. In other words, it is a surgery to correct tear blockage, surgery to establish a new passage for the tears from the tear sac into the nose. The surgery can be performed using a laser with the aid of digital microscope probe through a nostril. They have studied thru many patients or subjects around two hundred and more eyeballs were examined for further tests. Epiphora, or abnormal tearing, occurs because of blockage in the lacrimal drainage system, which impairs normal tear channeling into the nose. Recurrent infection may also occur as a result of the stagnation.
The dacryocystorhinostomy operation, which involves fistulization of the lacrimal sac into the nasal cavity, may alleviate the symptoms. The operative approach to the sac may be external or endoscopic. The latter approach may use rigid telescopes or the microscope. The endoscopic approach has several advantages and disadvantages. And advantage is that it provides better aesthetic result with no external scar and it allows a one-stage procedure to also correct associated nasal pathology that may be causative. Some disadvantages however, it requires specialized training in nasal endoscopic surgery and it that the endoscopic equipment is very expensive. Read more