An easy method for intraoperative confirmation of lacrimal sac patency in endoscopic dacryocystorhinostomy

Fabio Pagella, Alessandro Pusateri, Elina Matti, Paolo Carena, Luis Quiroa, Elena Antoniazzi, Enzo Emanuelli

Research output: Contribution to journalArticle


Purpose: Few studies have focused on the intranasal localization of the lacrimal sac during endoscopic dacryocystorhinostomy: landmarks in order to find the medial wall of the lacrimal sac have been described, but there is a lack of description of methods for the verification of the complete marsupialization of the lacrimal sac during surgery. In this report, we propose an easy and effective method for certain intraoperative identification of lacrimal sac. Methods: A method in order to verify the effective marsupialization of the lacrimal sac is applied and described: to ensure that the opening of the sac in the nasal cavity is complete, the surgeon should identify the Rosenmuller valve, which is the end of the common canaliculus in the lacrimal sac. Continuous irrigation with saline solution through the inferior canaliculus can be useful to obtain a clean surgical area and to permit easy intraoperative identification of the valve. Results: Between 2007 and 2015, 193 endoscopic dacryocystorhinostomies were performed in our institutions. Postoperative surgical success at last follow-up (minimum 12 months) was 93.8% (181 out of 193 of cases). No major complications were observed. Conclusions: Correct and complete exposure of the lacrimal sac during surgery is crucial for a good outcome: when the opening of the common canaliculus is identified, the surgeon is assured that the sac has been correctly and completely marsupialized inside the nasal cavity.

Original languageEnglish
Pages (from-to)379-381
Number of pages3
JournalEuropean Journal of Ophthalmology
Issue number3
Publication statusPublished - May 1 2017


  • Dacryocystitis
  • Dacryocystorhinostomy
  • Endoscopic surgery
  • Epiphora
  • Lacrimal anatomy
  • Lacrimal pathway

ASJC Scopus subject areas

  • Medicine(all)
  • Ophthalmology

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