METHOD OF RENEWING LACRIMAL FLUID DRAINAGE BY LACORHINOSTOMY OPERATION WITH PERMANENT INTUBATION

摘要

FIELD: medicine.;SUBSTANCE: lacorhinostomy operation with permanent intubation is performed. Endosurgery step is performed endonasally. "П"-shaped flap is cut out from mucous membrane of lateral wall of nasal cavity, flap is removed and within the flap limits hole in bone is formed. Microsurgery step is performed under microscope from the side of internal corner of palpebral fissure, for which purpose lacrimal caruncle is partly dissected, into cleared space ophthalmological trephine with external diametre 1.5-2 mm is installed, and giving it inclination bottomward and medially, tunnel with exit to rhinostoma is formed in soft tissues. Into formed trephine canal by means of guide-probe lacoprosthesis is introduced, which is passed through rhinostoma. Proximal end of lacoprosthesis, made in form of "cap" is fixed. Rhinostoma is made in projection of lacrimal fossa bottom and beginning of nasolacrimal canal, and during canal formation trephine is given inclination 50-60° to horizontal plane and it is passed through soft tissues and lacrimal sac towards rhinostoma. As lacoprosthesis, flexible lacoprosthesis 40 mm long with external diametre 2 mm is used. When distal end of lacoprosthesis appears in rhinostoma lumen, it is gripped endonasally with tool and laid in general nasal passage onto nasal cavity bottom, and proximal end of lacoprosthesis is fixed with loop suture to skin of nose dorsum for 2-4 week term.;EFFECT: method allows to form reliable way of lacrimal drainage and reduce traumatism due to application of unified lacoprosthesis, which eliminates its two-phase introduction.;4 cl, 1 dwg, 1 ex