Purpose of the study. Modification of the technique of the combined operation of endonasal endoscopic dacryocystorhinostomy (EEDCR) with simultaneous correction of intranasal structures..

Material and methods. 13 patients (18 eyes) with chronic dacryocystitis in combination with various pathologies of the nasal cavity and paranasal sinuses were examined. The age of patients ranged from 31 to 65 years, mean age 48±2.5. Concomitant pathology of the nasal cavity and paranasal sinuses: deviated septum - 4, hypertrophy of the middle turbinates - 4, combination of deviated septum with hypertrophy of the middle turbinate - 5.

Results. All patients with deformity of the nasal septum and hypertrophy of the turbinates were started with their elimination in the form of septoplasty, conchotomy, or lateroposition of the middle turbinates. Intervention on the lacrimal ducts was started after preliminary anemization with 0.1% adrenaline under the control of a KarlStors 0 and 30° endoscope. The operation was performed according to the methodology proposed by the authors of the study. In order to prevent the development of synechia of the nasal septum from the lateral wall on both sides, silicone splints were introduced into the nasal cavity and fixed with through sutures on the septum for up to 10 days. In the area of the formed dacryocystorhinostomy, in combination with tubular plasty, a silicone tube was brought into the nasal cavity, into which loose ointment swabs were additionally inserted for 1-2 days.

In the postoperative period, systemic antibiotic therapy was prescribed for 5-7 days and corticosteroids with daily toilet of the nasal cavity for 7-10 days. Splints were removed after 10 days, silicone tubes after 3-6 months. In 2 patients, a granuloma was noted, which caused episodic epiphora.

Conclusion. Careful preoperative preparation, combined operations that prevent the development of synechia using modern technologies, and good postoperative care are the main factors in the effectiveness of the treatment of this pathology.

Chronic dacryocystitis, dacryocystorhinotomy, combined operations