Transplantation of the parotid duct to the inferior conjunctival cul-de-sac1,2 has proven to be a vision-saving measure in total xerophthalmia. While this procedure alleviates discomfort and prevents further visual loss, it is accompanied by an epiphora resulting from the excessive parotid secretions, particularly with olfactory or gustatory stimulation. The epiphora is further accentuated because the normal lacrimal drainage system is frequently completely obliterated by the disease process which produced the total xerophthalmia. However, even the normal lacrimal drainage system would be totally inadequate to handle the flow of parotid secretions. The normal lacrimal secretion has been estimated at 1 cc. or less3 per 24 hours, in contrast to a parotid flow of approximately 750 cc. per 24 hours.4 Thus it is apparent that in order to prevent epiphora after parotid duct transplantation, one must provide a drainage system many times more efficient than the normal lacrimal
BENNETT JE, ARMSTRONG JR, JONES RE, SCHILLER F. Conjunctivoantrorhinostomy: A Gravity Drainage Operation Utilizing the Maxillary Sinus, with Report of Two Cases. AMA Arch Ophthalmol. 1959;62(2):248–254. doi:10.1001/archopht.1959.04220020074011
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