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.

Congenital dacryostenoses are frequent problems in pediatric ophthalmology. For surgical intervention various transcanalicular techniques by lining the tear ducts with silicone tubes are available. A 5-year-old child was presented with severe chronic dacryocystitis of both eyes after several interventions for lacrimal duct surgery with silicone intubation had been carried out. Using endoscopy the fragments of intrasaccal silicone tubes could be localized and the foreign bodies could be removed by endoscopic transcanicular surgery. The complete removal of silicone tubes is obligatory otherwise severe complications can occur.

Syringing under local anesthesia is an effective therapy. The highest success rates were found at the ages of 1-6 months. Therapy with additional silicone tube intubation was highly successful.

DE is a diagnostic and therapeutic option for complex CNLDO in patients before the age of 1 year. The outcome of DE in the 3 months follow-up is highly indicative of positive final results in terms of patency of the lacrimal duct.