Atlas of Nose and Paranasal Surgeries

ATLAS OF NOSE AND PARANASAL SURGERIES 27 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 h. Lacrimal bone drilling with piezosurgery. An interesting type of instrument is represented by piezosurgery, that can be often used in this step. The peculiarity of this technology is that a better respect of soft tissue and no hot damage is produced, on the contrary of drill. This technology consents to make an exeresis of only bone tissue, with maximum respect of nerves, vessels, muscles, and in general, soft tissue. The use of this instrument causes, on the contrary, a delay of surgical time. (continued)... of only studies. ne and er may conse- by the one. In asi, the anterior ed with to sinus resting ezosur- eculiar- pect of , on the ents to e, with uscles, instru- urgical 6.5.7 Lacrimal Sac Opening To ide tify with precision the medial wall of the lacrimal sac, a transillumination through the infe- rior lacrimal canaliculus with otic fibers can be made (Fig. 6.2b ). Alternatively a sickle knife Fig. 6.8 ( a , b ) Lacrimal bone drilling with piezosurgery ...(continued) h