ANTERIOR SUSPENDED FLAPS - A MODIFIED APPROACH FOR EXTERNAL DACRYOCYSTORHINOSTOMY

Background/aims-External dacryocystorhinostomy (DCR) is a reliable but difficult surgical technique for the treatment of any obstruction of the lacrimal drainage system lying distal to the internal opening of t he common canaliculus. In this prospective study, a simplified externa l DCR procedure and the results obtained on a series of 45 consecutive patients, in which traditional external DCR was indicated, are descri bed. Methods-In this modified procedure only very large and mobile ant erior flaps of the lacrimal sac and nasal mucosa are created. Thanks t o the large size and the great motility the two flaps can be easily su tured. Two double armed 6/0 polyglycolic acid sutures are used to join the two flaps, to elevate them anteriorly in order to avoid adhesions with underlying tissues, and to approximate the deep planes of the mo und. The mean operative time was measured. Results-At the end of follo w up period (mean 17 months, range 14-24 months) all patients had no s ign or symptoms of tearing and normal Jones I dye test. The mean opera tive time was 28.6 minutes (range 23-44 minutes) Conclusion-We believe that our modified technique can be used to simplify and speed up trad itional external DCR without decreasing its well known reliability.