ASOPRS 2014 Fall Syllabus - page 164

ASOPRSFall Scientific SymposiumSyllabus
164
T11
The J-Curve forNavigating theNasolacrimalOutflowTract
Katie Finnerty
1
, RonaldMancini
2
.
1
Ophthalmology, University of TexasSouthwestern, Dallas, TX, UnitedStates, 
2
Ophthalmology,
University of TexasSouthwestern, Dallas, TX, UnitedStates
Introduction:
To describe the technique of J-shapedmanipulation of themetallic stent for instrument-free intubation of the
nasolacrimal outflow tract after dacryocystorhinostomy.
Methods:
The internal diameter of the J-shaped curve placed in the intubation stentswasmeasured and the technique of intubation
of the nasolacrimal outflow tract and out the external naris is described.Additionally, the anatomic relationships of the nasolacrimal
system are illustrated and videographed in relation to the described procedure.
Results:
This technique has been used successfully on 50 endoscopic dacryocystorhinostomy cases.After completion of bony
osteotomy and opening of the nasolacrimal sac, themetallic portion of the stent is bent into a J-shaped curvedwith an average
internal diameter of 4 cm (Image 1).The punctum is then canulatedwith themetallic stent and directed 2mm vertically then 8-10mm
medially along the path of the canalicular system. Upon entering the osteotomy the stent is directed inferior and slightlymedial in the
direction of the external naris (Image 2). Gentle advancement with small angle redirection of the stent as needed allows exit through
the external nariswithout using additional instrumentation in the nose (Video 1).
Conclusions:
The authors present a technique of J-shapedmanipulation of the intubation stent allowing navigation of the
nasolacrimal outflow tract and exit through the external nariswithout additional instrumentation.This technique offers advantages
over instrument-assisted retrieval of the intubation tube. First, the J-Curve technique is faster thanmulti-instrument retrieval. Second,
less damage is incurred to themucosa of the lateral nasal wall and/or septum secondary to blind placement of a Crawford hook,
hemostat, or grooved director.
DetailedProgram
—Thursday,October 16, 2014
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