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|Symptomatic epiphora from nasolacrimal duct obstruction|
|Primary dacryocystorhinostomy (DCR) failure|
|Endonasal examination to identify cause of DCR failure: |
|Lacrimal probing and irrigation|
Suturing of the nasal mucosal and lacrimal sac flaps is routinely performed during external dacryocystorhinostomy (DCR). The open approach afforded by the external skin incision and direct visualization allows meticulous suturing of these flaps. However, within the narrow field provided by the endoscopic approach, flap suturing is particularly challenging owing to poor surgical access. In this chapter, flap suturing during endonasal DCR is presented. While this may be considered as an optional adjunct during primary endonasal DCR, flap suturing may be more appropriately applied for cases of failed external or endonasal DCR.
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