The debates on operations on the tear passages appear, for the most part, to be concluded. Each operator has settled down with the method which he likes best and apparently does not find it necessary to add anything new. Yet the procedure which was recently reported by Blumenfeld1 is so unique and original that it necessitates a brief discussion.
Blumenfeld reported a case in which, after four previous operations on the tear sac, two fistulas formed in the skin, 0.5 cm. medial to the inner canthus. These fistulas represented the distal openings of the upper and lower canaliculi. He excised an oval piece of skin containing the two fistulas. Then, through a window in the bony lateral nasal wall, he exposed the nasal mucous membrane, incised it longitudinally and inserted the oval flap of skin, with the canaliculi attached, into this opening in the nasal mucous membrane. He then
Waldapfel R. RHINOCANALICULAR ANASTOMOSIS. Arch Ophthalmol. 1944;31(5):432–433. doi:10.1001/archopht.1944.00890050086011
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