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Query: UMLS:C0278134 (anesthesia)
 110,339 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Obstruction of the nasolacrimal duct is a major cause of epiphora, or tearing. The authors describe a method of dilating obstructions to re-establish drainage of the lacrimal sac which utilizes fluoroscopic control to stay within the natural lumen of the nasolacrimal duct. The procedure is simple to perform under local anesthesia. An unsuccessful dilatation does not interfere with subsequent dacrocystorhinostomy.
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PMID:Dilatation of the nasolacrimal duct under radiographic control. 66 84

Careful preoperative evaluation and observance of indications for dacryocystorhinostomy (DCR) result in the appropriate use of this procedure. The surgeon should have a sound knowledge of the anatomy of the lacrimal drainage system and nose before proceeding with a DCR, which may be done under local or general anesthesia. A method of performing a DCR is described in detail, with postoperative management and treatment of possible postoperative complications discussed.
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PMID:Dacryocystorhinostomy. 74 32

The Schirmer tear test for the measurement of tear formation in the dog was done according to 2 procedures: Schirmer I (the conventional procedure) and SCHIRMER II (with topical anesthesia and drying of the ventral conjunctival fornix. Results from 97 normal dogs averaged 21.0 mm wetting/minute (standard deviation (sd) plus or minus 4.2 mm) for the Schirmer I test and 11.6 mm wetting/minute (sd plus or minus 6.1 mm) for the Schirmer II test. When atropine was injected subcutaneously in 50 dogs (0.02 mg/kg, wetting/minute averaged 9.36 mm (Schirmer I) AND 4.32 MM (Schirmer II). Two dogs in each of 3 groups had either the lacrimal gland, gland of the membrane nictitans, or both excised. Changes in tear formation were evaluated by Schirmer I and II tear tests, as well as after parenteral administration of atropine. The lacrimal gland, the gland of the membrama mocotams. amd tje accessory lacrimal glands and mucous cells were found to contribute 6.17, 35.2, and 3.1%, respectively, to tear formation.
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PMID:Evaluation of tear formation in the dog, using a modification of the Schirmer tear test. 111 54

Eighty-nine patients with lacrimal sac phlegmons, 76 women and 13 men, aged 16 to 78, were administered multiple-modality treatment, consisting in Group 1 (43 patients) of traditional methods, such as UHF therapy, antibiotics, sulfonamides, symptomatic therapy, dacryocystorhinostomy after complete cessation of inflammation, and in group 2 (46 patients) including sessions of intermittent magnetic field (IMF) exposure, antibiotics, and early dacryocystorhinostomy. Sparing technique was used in all operations, carried out under local anesthesia with 2% procaine or trimecaine. IMF exposure was found to be an effective therapeutic means characterized by antiinflammatory, resolving, and analgesic effects. IMF sessions and early dacryocystorhinostomy enhance cessation of inflammation and improve the treatment efficacy: remote results of surgery were excellent in 80% of Group 1 patients and in 90.9% of Group 2 patients; As a results of IMF exposure, the terms of medical and social rehabilitation of patients with the lacrimal sac phlegmons were reduced twofold.
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PMID:[Our experience with the complex treatment of phlegmon of the lacrimal sac]. 148 21

Twenty-five newborns with acute dacryocystitis underwent probing of the nasolacrimal duct. All had a resolution of the acute dacryocystitis. Only one continued to have epiphora and had to undergo a subsequent probing with silicone intubation at 9 months of age. All were probed without anesthesia, being mummified and held by nurses while the author performed the probing. Only five were treated with parenteral and topical antibiotics for a week prior to probing while 20 were probed without any prior antibiotic therapy. Additionally, five of six mucoceles of the lacrimal sac which did not resolve in the 1st 2 weeks of life with massage were successfully probed without anesthesia. Four of the five mucoceles had developed an acute dacryocystitis on conservative management. Probing of the nasolacrimal duct in the newborn period is a safe and successful approach for acute dacryocystitis. It is a highly successful procedure for the treatment of acute dacryocystitis with a very low morbidity rate.
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PMID:Treatment of acute dacryocystitis in neonates. 175 61

Increasingly today, dacryocystorhinostomy seems to be the common obligatory path to functional surgery in case of traumatic lesions of the lacrimal ducts. The endonasal approach provides direct access to the nasolacrimal canal, while permitting to avoid the cutaneous approach through tissues that may be coming apart. The use of optic endoscopes renders the operation easier and provides access to the dome of the lacrimal sac, which is impossible under conventional endonasal microscopy. Monitoring and postoperative care are carried out with the same instrument, thereby improving the quality of the end result. The operation usually takes place under potentiated local anesthesia and lasts one hour, on average. The various surgical steps are described and particular attention is given to endonasal localization of the lacrimal ducts and to the technique of marsupialization.
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PMID:[Fiber optic endoscopically-guided intranasal dacryocystorhinostomy in post-traumatic surgery of the lacrimal ducts]. 213 Apr 61

The extraorbital and intraorbital lacrimal glands, the Harderian glands, and the submandibular glands of five rats were excised after ethanol perfusion under general anesthesia. Indirect immunohistochemistry with antibodies specific to epidermal growth factor (EGF) was performed. EGF-like immunofluorescence (EGF-LI) was shown to be present both in the lacrimal glands (extra- and intraorbital) and in the submaxillary gland. In the lacrimal glands the specific immunoreaction appeared within the lumen of the acini and the cells of the tubular ducts close to the acini. Only faint EGF-LI was observed within the acinar cells. The submandibular glands showed intense EGF-LI only in the cells of the granular convoluted tubules. The Harderian gland did not show any EGF-LI. The results strongly support the idea that the lacrimal gland is a source of EGF in tear fluid (TF). Diseases of the lacrimal gland therefore may lead to decreased concentrations of EGF in tears. This may account in part for the pathophysiology of tear deficiency syndromes and may serve as the basis of a new rationale for the external application of EGF.
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PMID:Immunohistochemical demonstration of epidermal growth factor in the lacrimal and submandibular glands of rats. 222 Mar 66

Combinations of these procedures have been performed on more than 50 patients to date, with the longest follow-up being greater than 8 years. All of these patients presented with complaints of ocular irritation, tearing, photophobia, and impaired vision. Several had severe epithelial keratopathy. Some patients have also been treated following neurosurgical procedures which caused paralysis of the fifth and seventh cranial nerves, resulting in both corneal anesthesia and facial paralysis. Patients have done very well after these procedures and have achieved ocular comfort, reduced tearing, and corneal protection without the need for disfiguring and visually occluding tarsorrhaphies or other procedures. In some instances, they may still require artificial tears during the day or a lubricating protective ointment for the eye at bedtime. There have been no significant complications in this series; no cases of gold weight extrusion, recurrent ectropion, or persistent corneal epithelial keratopathy. Some patients have complained of continued excessive tearing which is most likely due to paralysis of the lacrimal pump, resulting in ineffective tear drainage to the nasal lacrimal duct. However, these patients have still noted markedly reduced tearing compared to their preoperative condition. One patient underwent secondary release of her medial canthoplasty following return of facial nerve function.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Ophthalmic surgical management of facial paralysis. 223 Jul 7

The classical operations to treat either medial canthal tendon laxity or punctal aversion occurring alone possess drawbacks if they are used to treat these conditions when they occur simultaneously. A simplified procedure is described whereby tissue is removed via a posterior eyelid approach so that the eyelid may be tightened both horizontally and vertically, thus inverting the punctum and fixating it in the lacrimal lake. This procedure is quite easy to perform and can be done under local anesthesia in the office.
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PMID:Posterior horizontal and vertical tightening to treat combined punctal ectropion with medial canthal tendon laxity. 225 Aug 57

Primary dacryocystorhinostomy (DCR) failure is commonly due to scarring at the rhinostomy site. Nasolacrimal duct obstruction due to scarring may also occur in patients who have had their lacrimal bone removed during maxillary sinus surgery. Five patients following DCR and 3 patients after sinus surgery, all with constant epiphora, underwent endoscopic reconstruction of their lacrimal drainage system. Preoperatively, patency of the bony ostium was determined either by computed tomographic (CT) scan or dacryocystography. Endoscopically, the lacrimal drainage system was reopened then intubated with a silastic stent. Any scar tissue was visualized endoscopically and resected. Seven of the 8 patients have been followed from 3 to 24 months after stent removal, and all have had relief of their epiphora. Endoscopic repair is a useful adjunct in the management of patients with DCR failure or patients with epiphora after removal of the lacrimal bone during sinus surgery. This brief procedure can be performed under local anesthesia, does not require a skin incision, and allows the evaluation and correction of intranasal pathology.
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PMID:Endoscopic repair of failed dacryocystorhinostomy. 226 14


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