A NEW METHOD OF SILICONE INTUBATION OF THE LACRIMAL PATHWAYS
The method of bicanalicular silicone intubation of tear ducts is widely used as a stage of external and endonasal dacryocystorhinostomy, as well as during recanalization of the tear duct. The introduction of a silicone stent is the most common way to prevent rhinostoma closure. Its purpose is to maintain the permeability of the tubules or anastomoses during the healing period and can improve the results of surgical treatment if used correctly. Typically, pre-packaged kits consisting of silicone tubes attached to metal probes are used for the drainage implantation procedure. The disadvantages of using such kits are their high cost, insufficient length of metal probes when using them after dacryocystorhinostomy, and invasiveness of the procedure in the absence of visual inspection. The aim of our work was to develop a new method of silicone intubation of tear ducts, devoid of the described shortcomings. Material and methods. Silicone tubes 200 mm long were used as the lacrimal intubation kit. A line was antegradely conducted along the probe, which was then removed from the nasal cavity with a hook by endoscopic control. The procedure was repeated with the paired tear duct. Then the silicone tube was tied by both ends of the fishing line and passed to the free ends of it from the nose into the nasal cavity, where they were riveted and clipped. Results and discussion. In all cases, the drainage was performed as described. As in the case of other modifications of the drainage, holding the tube into the tear-nasal canal required more effort and more skill as compared to draining of the formed anastomosis. In all cases, the effectiveness of the method of holding the tube in the lacrimal duct depended on the severity of the obstruction. Conclusions. The method developed by us for carrying out a silicone tube into the lacrimal duct is effective, simple and does not require the use of complex technologies for the manufacture of an intubation kit.
About Authors (Correspondence):
Shkolnik G.S. – ophthalmologist of the department of outpatient surgery and conservative methods of treatment, e-mail: email@example.com