[Endonasal anatomy of lacrimal sac and its clinical significance in dacryocystorhinostomy].
OBJECTIVE
To explore the intranasal surface localization of the lacrimal sac in endoscopic dacryocystorhinostomy.


METHODS
Fifteen adult cadavers (30 sides) were studied, the data of projection position of the lacrimal sac on the lateral wall of nasal cavity were measured.


RESULTS
In 2/3 cadavers, the lacrimal sac is located above the axilla of the middle turbinate, and 1/3 lies below it. A majority of the lacrimal sac (2/3) are located below the entry point of the common lacrimal canaliculus, about 1/3 lies above it. Inner canthal ligament projects on the middle of the lacrimal sac, almost equal to the level of common lacrimal canaliculus. Thirty-two cases (thirty-nine sides) of chronic dacryocystitis were followed-up > 6 months after operation. Thirty-five sides were cured, 2 sides improved and 2 sides ineffective. The cure rate was 89.8%, improve rate 5.1% and ineffective rate 5.1%, respectively, and the total effective rate was 94.9%.


CONCLUSIONS
The central position of dacryocystorhinostomy should be 0.2 cm above the front of the axilla of the middle turbinate, to make an curved mucous membrane incision 0.8 cm above and 0. 4 cm below the front of the axilla of the middle turbinate and bone ostium about 1.2 cm x 1.0 cm. It is the best position in endoscopic dacryocystorhinostomy. Locating the inner canthal ligament with a bayonet type forceps to find the projection of lacrimal sac is also a simple and easy method.
Zhang
Su-Qin
SQ
Department of Otoyhinolaryngology, Changhai Hospital, Second Military Medical University, Shanghai 200433, China. suq_zhang@163.com
Jia
Pei-Liang
PL
Tang
Hai-Hong
HH
Liu
Feng
F
Shen
Xiao-Hua
XH
Wang
Su-Min
SM
Li
Zhao-Ji
ZJ
Jiang
Man-Jie
MJ
D000328:Adult; D000368:Aged; D000718:Anatomy, Regional; D002908:Chronic Disease; D003607:Dacryocystitis / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000033:anatomy & histology* / Q000601:surgery; D055815:Young Adult