It has been necessary recently on several occasions to defend experiences and ideas relative to the Mosher-Toti combined intranasal and extranasal dacryocystorhinostomy. My experiences with this operation have been so satisfactory that some doubt exists as to whether this valuable procedure is receiving its due.
I have performed thirty-three operations of this type and have assisted at several more cases extending over a period of about six years. Following one of these, a conversation with an internationally known ophthalmologist resulted in the decision to try to clear up some of the doubt and conjecture connected with the operation. The indications and reasons for recommending it, together with its rationality, should first be considered.
Several years ago, while working at the Palo Seco Leper Colony in the Panama Canal Zone on the rôle of the lacrimal sac in the causation of the ocular complications of leprosy, opportunity arose