New developments of the endoscopy of the lacrimal systems

Background At the moment digital dacryocystography yields the most exact results in lacrimal diagnostics. The main disadvantage lies in the dependancy of high tech X-ray systems and an angiography unit, which raise enormly the costs of the examination. Recently a new diagnostic system of the lacrimal pathway is available. Patients and Methods Miniaturizing of endoscopes and new developements in the fiberoptic technology made it possible to introduce these miniendoscopes into the canaliculi and perform antegrade examination of canaliculi, lacrimal sac and ductus nasolacrimalis. 86 patients agreed to this examination. With this examination a direct visualisation of the mucous membrane of the lacrimal pathways and possible pathological alterations were possible. Results In case of axial illumination and syringing of the lacrimal system good visibility can be achieved and an exact examination is possible. Especially for endoscopy modified probes of Bangerter provide an exact examination at narrow areas and areas of bendings too. Different reasons for stenosis of the lacrimal pathways could be identified, especially 2 cases of a lacrimal sac tumor. Conclusions The use of this new miniendoscope provides a very good examination under direct visualisation of the lacrimal pathway independant of a high tech x-ray equipment. The goal is to use this new endoscope on the one hand only for diagnostic reasons as endoscope and on the other hand in combination with a laser fiber to perform an antegrade laser dacryocysto-rhinostomy.