title: [Transnasal anchor suture for facilitating silicone tube intubation in deep congenital nasolacrimal duct stenosis].
abstract: BACKGROUND
  In silicone intubation of the nasolacrimal duct for congenital obstruction, retrieval of the guide thread behind the inferior turbinate can be difficult and time consuming. To facilitate this maneuver a modification of the conventional technique has been developed.
  
  
  METHODS
  In the conventional technique, a hollow probe was inserted into both lacrimal puncti and pushed downward into the nasal cavity. A guide thread was forwarded into the pharynx. Using the same hollow probe, a third guide thread was inserted transnasally and also forwarded into the pharynx. These three threads were pulled out of the pharynx transorally and tied together. Pulling on the nasal aspect of the transnasal guide brought all guides back into the pharynx and out of the nose. The intubation was completed in the conventional way.
  
  
  RESULTS
  The new method was evaluated in 13 children. With the conventional technique the mean duration of the operation was 35 min, but the time required varied greatly among individuals due to retrieval of the guides. In contrast, no guide retrieval problem occurred using the new technique, and the average duration was reduced to 25 min. No adverse effect was observed.
  
  
  CONCLUSIONS
  Using a simple modification, difficulties with the retrieval of the guide thread could be avoided, thus facilitating the procedure of nasolacrimal duct intubation and reducing its duration.
authors.affiliation: Augenklinik der Ludwig-Maximilians-Universität München. hschworm@ak-i.med.uni-muenchen.de
authors.forename: H D
authors.initials: HD
authors.lastname: Schworm
authors.forename: G
authors.initials: G
authors.lastname: Rudolph
authors.forename: V
authors.initials: V
authors.lastname: Klauss
authors.forename: K P
authors.initials: KP
authors.lastname: Boergen
mesh_terms: D002648:Child; D002675:Child, Preschool; D003608:Dacryocystorhinostomy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D007223:Infant; D007767:Lacrimal Duct Obstruction / Q000151:congenital* / Q000628:therapy; D008297:Male; D013536:Suture Techniques