Foreign bodies and dacryoliths are important differential diagnoses in the treatment of chronic dacryocystitis. Different surgical approaches are possible and should be available for treatment. Patients' history often reports prior lacrimal surgery.

LTS of ext-DCR shows very good results, thus underlining its superiority to other surgical approaches. Special attention should be paid to diseases and previous surgical interventions on the nose and/or sinus that effect the lacrimal duct system. Therefore, a special committee of ENT physicians and ophthalmologists has been established at the Department of Ophthalmology, University Hospital Halle. From the surgical point of view, it is important to create an adequate mucosal anastomosis using lacrimal and nasal mucosa. Restoration is possible with lacrimal stent materials. The indication for ext-DCR was restricted by competition with transcanalicular endoscopic interventions to preserve physiological lacrimal drainage.

No abstract

In lacrimal system lacerations the canaliculi are involved in 70% of cases and the lacrimal sac and/or nasolacrimal duct in 30%. Lacrimal system lacerations can be the result of sharp or blunt trauma. Nasolacrimal ducts may become obstructed by indirect trauma as an aftereffect of naso-orbital fractures. The epidemiology, main principles of surgical repair of canaliculi and of lacrimal sacs and/or nasolacrimal ducts, special techniques of surgical reconstruction and approximate success rates are reviewed with respect to the outcome of our patient collective compared to the literature. Canalicular and lacrimal sac lacerations need urgent primary microsurgical repair with silicone intubation and paying special attention to the medial nasal canthus. In cases of traumatic nasolacrimal duct obstruction as an aftereffect of mid-facial fractures, a secondary reconstruction should be planned.