Interactive image-guided endoscopic dacryocystorhinostomy

Shelley Day, Thomas N. Hwang, Steven D. Pletcher, Amol Bhatki, Timothy J. McCulley

Research output: Contribution to journalArticlepeer-review

15 Scopus citations


The authors describe dacryocystorhinostomy performed with CT guidance. A 53-year-old man with a history of cocaine abuse was referred for bilateral nasolacrimal duct obstruction. Nasal speculum examination revealed an oronasal fistula and obliteration of the inferior nasal septum. Bilaterally, the inferior and middle turbinates were contracted, forming thick scar tissue conglomerates. The loss of normal anatomic landmarks and extensive contracted scar tissue precluded standard dacryocystorhinostomy approaches. Endoscopic dacryocystorhinostomy was therefore undertaken using CT-guided navigation. The location of the superior nasolacrimal duct was identified and subsequently exposed. Dissection was continued superiorly, marsupializing the lacrimal sac. Silicon stents were placed and tied intranasally. Right and left sides were managed similarly. Several months later, following stent removal, the patient was without epiphora. This case demonstrates that CT guidance can be a useful adjunct to standard dacryocystorhinostomy techniques, allowing otherwise challenging surgical cases to be managed effectively and safely.

Original languageEnglish (US)
Pages (from-to)338-340
Number of pages3
JournalOphthalmic plastic and reconstructive surgery
Issue number4
StatePublished - Jul 2008
Externally publishedYes

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology


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