Talk with your doctor about what will happen during the procedure. The details of your surgery will differ if it is an external or an endoscopic approach. Usually, a doctor trained in ophthalmic plastic surgery performs the external surgery or partners with a sinus surgeon to perform an endoscopic DCR — in either case, with the help of a team of specialized nurses.
In general, you can expect the following during your surgery:. Ask your doctor about what you should expect after your external DCR surgery. Your nose may need to be refilled with packing material to reduce the chance of bleeding. In most external and endoscopic DCR cases, you will be able to go home the same day.
Plan to have someone go home with you after the procedure. You may need to take antibiotics or antibiotic eyedrops to help prevent infection. Your doctor might also give you instructions about rinsing the nasal cavity. You may need other medicines too, such as steroids and nasal decongestants. There may be a little soreness after the procedure, but over-the-counter pain medicines should relieve the discomfort. It is normal to have some bruising after an external DCR.
There is typically no bruising after an endoscopic DCR. Ask your doctor if there are activities you should avoid while you recover. You will need close follow-up care with your doctor to find out if the surgery was effective. You may have a scheduled appointment soon after the procedure.
You will need continued follow-up care to monitor how you are doing after your surgery. If a stent was placed, it might need to be removed a few weeks after the procedure. Tell your doctor right away if you have excessive bleeding, a fever, or increasing pain or swelling. The Johns Hopkins Sinus Center provides state-of-the-art evaluation and management for patients of all ages with sinus and allergy disorders. The use of blood thinners such as coumadin and aspirin should be discussed individually with Dr.
You will be asked to use an antibiotic ointment on your wound three times per day beginning the day after surgery. The antibiotic ointment should be continued until the sutures are removed.
A dressing will be placed on the wound. This dressing can be removed the morning after surgery. A gauze may also be taped under your nose to catch any nasal discharge. This gauze may be removed when you get home from surgery or sooner if desired. You should not work in the yard, get the wound dirty, or go swimming for two weeks following surgery. However, you may wash your hair, bathe, or go to the hairdresser beginning the day after surgery.
If dried blood and discharge builds up on the wound you should clean the wound with peroxide on a Q-tip. If you notice pus, fever, or marked redness and tenderness of the wound you may have an infection. Please call our office. Not every condition is listed. Consult Dr. Goldberg if you have any questions about a condition not described here. Tear Duct Surgery. Treatment of Tear System Blockage When the nasolacrimal duct, the tube which drains tears into the nose, is blocked a surgical procedure is usually required.
During this procedure, called a DCR Dacryocystorhinostomy , a hole is created between the tear sac and the inside of the nose. When the nasolacrimal duct is only partially blocked your doctor will often attempt to widen the opening by flushing water through the duct. An eyedrop with both anti-inflammatory and antibiotic medications will then be prescribed in an attempt to reduce the swelling in the duct and promote tear drainage.
These attempts to open the duct are often successful but may need to be repeated periodically When the tubes, called cannaliculli, which drain the tears into the lacrimal sac are blocked surgical therapy is more complicated.
In most cases both a DCR and reconstruction of the cannaliculli will be performed. Eyelid weakness or malposition may be treated by surgically tightening and repositioning the lids. Then they flush the duct with sterile water to make sure the pathway is clear.
This is the procedure most often used for blocked tear ducts. The tubes stay in place for 3—6 months, then are removed either in the office or during another short procedure. This expands the tear duct. The procedure takes about 10 minutes. Sometimes a tear duct can get blocked again. Your child should have very little discomfort after the procedure. When Should I Call the Doctor?
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Diagnosis To diagnose your condition, your doctor talks with you about your symptoms, examines your eyes and does a few tests. More Information Eye exam. Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Salmon JF. Lacrimal drainage system. Elsevier; Accessed Jan.
Nasolacrimal duct obstruction.
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