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October 1988

Flap Reconstruction Techniques in Conjunctivorhinostomy

Arch Otolaryngol Head Neck Surg. 1988;114(10):1103. doi:10.1001/archotol.1988.01860220037020

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Richard L. Arden, MD, and coworkers presented at the 1988 spring meeting of the American Academy of Facial Plastic and Reconstructive Surgery in Palm Beach, Fla, a solution to an unusual but difficult reconstructive situation.

Dacryocystorhinostomy is usually the standard approach to treat epiphora caused by lower lacrimal tract obstruction. When the pathologic cause lies in the upper lacrimal passage, however, alternate bypass or reconstructive options need to be considered. Conjunctivodacryocystorhinostomy, utilizing the Jones' tube, can effectively bypass the upper tract, but the technique may be complicated by granulation tissue formation, infection from unapposed mucosal flaps, and inefficient passage of tears through scar as a result of healing by secondary intention.

Canaliculodacryocystorhinostomy affords the advantages of a physiologic reconstruction, but it is limited by availability of sufficient canaliculus, requires a lengthy and tedious dissection, and needs a microsurgical approach. We describe an alternate technique of conjunctivorhinostomy (CR) that provides

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