Abstract
Two cases with epiphora following the surgery of the maxillary sinus were reported. In these cases we found that the inferior end of the lacrimal passage was closed by a cicatrical tissue.
Dacryocystorhinostomy by paranasal approach was perfomed under an operating microscope. An incision of about 50 mm long was made along the operative scar on the oral vestibule. Frontal process of the maxillary bone was exposed and anterior wall of the lacrimal canal was removed with a small straight chisel. The vault of anterior end of the inferior nasal meatus was the most easily recognizable marking in order to start the removal of anterior wall of the lacrimal canal. After exposure of the membranous nasolacrimal duct, its nasal wall was ovally excised about 7 to 10 mm in diameter. The mucoperiostal layer which covers the agger nasi was incised parallel to the posterior border of the new opening of the nasolacrimal duct. This newly made flap of the mucous membrane was placed anteriorly so that its external margin adapts to the anterior lacrimal flap with adequate tension. Then the both flaps were brought together with one or two sutures and tied.
Two patients treated by this method were relieved of epiphora. The dye test after the operation was positive in these cases.
