Dacryocystorhinostomy by intubation.

THE value of draining an infected sac into the nose was recognized 1500 years ago by surgeons of the Byzantine School, who performed a crude dacryocystorhinostomy by passing a cautery through the sac and lacrimal bone. But such openings made by simple penetration rapidly close, and much surgical ingenuity has since been devoted to the problem of fashioning a permanent communication. At the beginning of the 20th century, Toti (1904) laid the foundation of the modern operations of external dacryocystorhinostomy. Since then the careful work ofmany surgeonshas resultedin procedures which give a high percentage of success Traquair (1940), 80 per cent.; Scott (1949), dacryocystitis 99.4 per cent., epiphora 76.9 per cent.; Stallard (1950), 89 per cent.; Rycroft (1951), over 80 per cent. Despite these excellent results, dacryocystectomy is still being very generally performed because it is believed that dacryocystorhinostomy is successful only in exceptionally experienced hands, is time-consuming, is often beset with technical difficulties. and sometimes involves painful post-operative treatment.