Perforate the
lacrimal bone with Kerrison bone punch.
In 1 case, inflammatory process extends to the medial
lacrimal bone.
Length of the
lacrimal bone 1.30 0.23 12.56 forming orbital rim 24.
A 1-1.5 cm posteriorly based mucosal flap was elevated and removed from the
lacrimal bone to expose only that much part of
lacrimal bone.
(8,9) which occurs due to dissemination of infection from ethmoid to orbitary tissue due to bone refraction arising from osteitis involving the external wall of ethmoid, which corresponds to internal region of the orbit at the level of the
lacrimal bone. The paranasal sinuses are adjacent to the orbits and the walls are crossed by valveless vascular channels, presumably channels for migration of micro-organisms.
However complete visualization, removal of
lacrimal bone and control of excessive bleeding were the major problems unsolved with endonasal endoscopic dacryocystorhinostomy.
Once the lacrimal fossa is exposed, bone punching should be started at the junction of lamina papyracea of the ethmoid and
lacrimal bone.
There can also be extramural expansion of ethmoid cells outside the ethmoid to invade the frontal, maxillary, and sphenoid sinuses as well as the ascending process of the maxilla and
lacrimal bone. Encroaching cells are the rule, and one can find any pattern of intramural and extramural expansion, which should be considered normal variations and not anomalies.
This probe helps to identify the thin
lacrimal bone..
Lacrimal bone was fractured by blunt dissector and avoiding damage to nasal mucosa, bone was punched out and 1.5 cm bony opening was made.