Step-by-step dacryocystorhinostomy for beginners: An expert′s view

Chronic dacryocystitis occurs usually due to obstruction of lacrimal passage at the junction of the lacrimal sac and the nasolacrimal duct or within the bony nasolacrimal duct. Reconstruction of the lacrimal passages in such cases can be achieved by several surgical techniques, although external dacryocystorhinostomy (DCR), proposed by Ohm and by Dupuy-Dutemps and Bourguet in 1921, is still the most successful operation. Despite ease and decreased morbidity of endonasal DCR, external DCR is procedure of choice as it is more successful. Several ophthalmologists fear performing DCR because of bleeding and unfamiliarity of structure. This article tries to provide few tips to make DCR easy and stress-free. Proper case selection, pre-operative workup and adequate exposure go a long way in making DCR stress-free and successful. Excessive bleeding, a common hindrance in DCR surgery can be successfully tackled by proper positioning of patient, use of adrenaline, suction, and adjustment of nasal pack

Fibrous dysplasia of bone causing unilateral proptosis

Fibrous dysplasia (FD) is a slow growing benign noninherited disorder in which normal bones are replaced by fibrous tissue and immature woven bones. Here we report a case of 30-year-old female who presented with unilateral proptosis and lagophthalmos without any visual loss; was diagnosed with polyostotic FD. Patient was taken up for surgery. Osseous reconturing was done by shaving of involved facial bones. Postoperatively, there was a decrease in proptosis and lagophthalmos