Conjunctivorhinostomy without osteal perforation.

The present techniques of conjunctivorhinostomy require perforation of the frontal process of the maxillary bone to open a passageway between the conjunctival sac and the nasal fossa. A relatively complex operation is required, and an almost horizontal conduit is left, whose flow is rarely good. A new technique of conjunctivorhinostomy obviates the necessity for osseous perforation by passing a tube beneath the soft tissues of the face just superficial to the maxillary bone, between the lacrimal lake and the nasal atrium. The external diameter of the tube should not exceed 2 mm to avoid producing a visible elevation on the surface of the face. The almost vertical position of the tube and the placement of its inferior opening in the zone of maximal respiratory flow ensure good drainage of tears. The operation can be performed in a few minutes, with local anesthesia, in the surgeon's office.