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October 1962

Management of Epiphora Following Parotid Duct Transposition for Xerophthalmia

Author Affiliations

Bethesda, Md.; Los Angeles
Presently in the Ophthalmology Branch, National Institutes of Health, Public Health Service, U.S. Department of Health, Education, and Welfare (Dr. Nicholas).; Assistant Professor, Department of Radiology, University of California School of Medicine, Los Angeles (Dr. Brown).; From the Division of Ophthalmology and the Department of Radiology of the University of California School of Medicine, Los Angeles.

Arch Ophthalmol. 1962;68(4):529-531. doi:10.1001/archopht.1962.00960030533019

Transposition of the parotid duct to the conjunctival cul-de-sac has become an accepted method of treatment for advanced cases of xerophthalmia.1,4,7,9,11 However, the copious secretory activity of the parotid gland is not a totally satisfactory substitute for the modest secretory output of the lacrimal gland. It is not unexpected, following transposition of Stensen's duct, that epiphora is frequently an unpleasant and almost debilitating accompaniment to the therapeutic benefits of the procedure.1,11

The same scarring process which results in obstruction of the lacrimal gland ducts and subsequent xerophthalmia often leads to impairment or obliteration of parts of the lacrimal outflow pathway. Dacryocystorhinostomy, therefore, cannot be performed. The placement of tube skin grafts or the use of polyethylene tubing to form a connection between the conjunctival cul-de-sac and the nasal cavity, maxillary sinus, or the oral cavity still may not provide drainage adequate to prevent epiphora. The quantity of parotid

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