Atlas of Nose and Paranasal Surgeries

ATLAS OF NOSE AND PARANASAL SURGERIES 25 Authors: M. Trebbi, F. Mattioli, D. Soloperto, M. Bettini, L. Presutti Title: Endoscopic Dacryocystorhinostomy Book: Endoscopic Surgery of the Lacrimal Drainage System DOI: 10.1007/978-3-319-20633-2_6 © Springer International Publishing Switzerland 2016 f. Double mucosal flap technique. Many techniques are described to make mucoperiosteal flaps. Usually two flaps are performed, one little posterior and one bigger superior. Until flaps are superiorly and posteriorly moved, the bony wall that recovers lacrimal sac is exposed. Mucosal incision could be produced with many instruments, such as cold knife, radiofrequency knife, and laser technique. with or without powered instrumentation. The laser method appears to be less effective than cold steel endoscopic DCR, with success rates ranging from 64 to 85 % compared with a rate of approximately 85 % for cold steel proce- dures. The inferior results achieved with laser DCR may be the result of the size of the ostia created, because small-ostia DCRs created by Fig. 6.6 Double mucosal flap technique (continued)... ...(continued) f