Use of vinyl polysiloxane impression material to protect and identify the nasolacrimal sac in endonasal dacryocystorhinostomy.
To determine the role of vinyl polysiloxane impression material (trade name Reprosil) in endonasal dacryocystorhinostomy.
Case series of 15 consecutive endonasal dacryocystorhinostomies in which vinyl polysiloxane material was used to mark and protect the nasolacrimal sac. Vinyl polysiloxane is mixed from two tubes, then immediately injected in the sac through a preplaced 21-gauge cannula. It is important to be sure the cannula is in the sac to avoid false injection and extravasation. We have found it best to inject a small amount, usually 0.2 to 0.3 mL.
A patent osteum was successfully created in 13 of the 15 cases (87%). Complications included two cases of retained vinyl polysiloxane that necessitated removal through an external excision.
Endonasal dacryocystorhinostomy has several advantages compared with the external approach. There is no external scar and the bruising and swelling are substantially reduced, allowing patients to return to work more quickly. In addition, the adjacent nasal anatomy is directly visualized, allowing for simultaneous treatment of any relevant nasal pathology and precise manipulation of the nasal tissues.