Several transnasal, transnasal-transseptal, and external approaches for dacryocystorhinostomy have been described. The first two and especially the first have the disadvantage of limited visualization. The third leaves an external scar, disrupts the horizontal canilicular system, and requires manipulation of the medial canthal tendon. The method described, using nasal endoscopes, affords excellent visualization and precise control, while avoiding an external scar, the canilicular system, and the medial canthal tendon.
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