Prophylactic lacrimal intubation for protection of the nasolacrimal apparatus during elective orbital osteotomies.
The lacrimal excretory system may be damaged after midface trauma or tumor resection, or injured in association with elective osteotomies involving the medial and inferior orbital walls and rims. Epiphora or problems of recurrent purulent ocular discharge and dacryocystitis may arise. Using the technique described by Crawford, we recently began to intubate at the time of surgery the lacrimal systems of our patients undergoing total midface and orbital osteotomy. Examples of the outcome of this procedure are presented. There were no cases of worsened epiphora or dacryocystitis. We detailed the use of lacrimal intubation in patients who are at high risk for postoperative obstruction of the lacrimal excretory system. Although our study was small and uncontrolled, our intention is to draw attention to the potential of intubation as an adjunct to the craniofacial surgeon's usual procedures.
Posnick
J C
JC
Craniofacial Program, The Hospital for Sick Children, Toronto.
Oestreicher
J H
JH
Buncic
R
R
D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007440:Intubation / Q000379:methods*; D007765:Lacrimal Apparatus / Q000293:injuries*; D009915:Orbit / Q000601:surgery*; D010027:Osteotomy / Q000009:adverse effects*