title: Intubation of the ostium and nasolacrimal duct with a single self-linking silicone stent in external dacryocystorhinostomy.
abstract: OBJECTIVE
  To describe a stent placement method that eliminates stent prolapse in external dacryocystorhinostomy.
  
  
  METHODS
  A retrospective, institutional review board- approved case series of patients undergoing external dacryocystorhinostomy with an alternative stenting method. Following anastomosis of the posterior flaps, one arm of a Crawford silicone stent is passed through each canaliculus. Both arms are then passed through the nasolacrimal duct and retrieved in the inferior meatus. The 2 distal arms are redirected in the nose; one arm is looped around the proximal portions within the lacrimal sac and tied to the second arm. The stent is self-linked around the inferior turbinate.
  
  
  RESULTS
  Nine patients underwent external dacryocystorhinostomy with alternative stenting. None experienced postoperative stent prolapse. At last follow-up (average, 38 months; range, 5-102 months), 8 patients reported resolution of tearing and exhibited normal dye clearance. On compression of the lacrimal sac, none of these 8 patients exhibited reflux of stagnant tears or dye through the canaliculi.
  
  
  CONCLUSIONS
  This alternative method improves stent retention by using the inferior turbinate as a stopper to eliminate stent prolapse. The self-linking nature obviates the need and expense of additional biomedical devices.
authors.affiliation: Division of Ophthalmic Plastic/Reconstructive Surgery, Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA. jhui@med.miami.edu
authors.forename: Jennifer I
authors.initials: JI
authors.lastname: Hui
authors.forename: Erin M
authors.initials: EM
authors.lastname: Shriver
authors.forename: David T
authors.initials: DT
authors.lastname: Tse
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007440:Intubation / Q000379:methods*; D007767:Lacrimal Duct Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct; D010030:Ostomy; D011391:Prolapse; D012189:Retrospective Studies; D012826:Silicone Elastomers; D015607:Stents
chemical_list: D012826:Silicone Elastomers