35 See Chapter 3. A thorough evaluation of the nasal lacrimal duct system, including the inspection of both the upper and the lower puncta, is essential to ensure that they are not absent and to rule out seclusio punctum. 1. Afrin nasal spray may be given ~20 minutes preoperatively into the nostril to decrease bleeding. 2. Anesthesia: General Note: This may be performed in the office (with or without sedation) if the infant is small enough (usually younger than 6 months) to be restrained with a blanket or papoose board.
Probe and Irrigation
Indications
Tearing associated with a nasal lacrimal duct obstruction in a child.
There is a lower success rate in children older than 2 years and in adults.
Preoperative Procedure
Instrumentation
Punctal dilator
Bowman lacrimal probes
Nasal speculum
Headlight
Lacrimal cannula on a syringe
Fluorescein strip
Sterile saline
Flexible nasal suction cannula
Hemostat or Freer periosteal elevator (if infracture of the inferior turbinate will be performed)
Operative Procedure
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