One-flap Dacryocystorhinostomy.

DACRYOCYSTORHINOSTOMY, the operation of choice in chronic dacryocystitis, is performed in almost all cases in this clinic by a special technique. Toti (1904) first described the drainage of the lacrimal sac by removal of the bony wall. Kuhnt (1914) stitched the nasal mucosa to the periosteum. Ohn (1920) first sutured the nasal mucosa to the sac. The operation was modified by Dupuy-Dutemps and Bourguet (1921). Morgan (1938), Lyle (1946), Hallum (1948), and Hogan (1948) also described various methods. The epiphora which leads to constant wiping of the eyes is most annoying to the patient, and although dacryocystectomy makes the conjunctiva sterile, the tiresome symptoms of epiphora persist. Since 1956 all cases of chronic dacryocystitis have had the operation of dacryocystorhinostomy, except where it was contraindicated, as for example in the very young and the very old, or where there was bony disease. In two patients with lacrimal fistulae, the operation was performed with success.