Management of intra-operative bleeding during dacryocystorhinostomy surgery
Background & Objectives: Dacryocystorhinostomy (DCR) is the operation of choice for the management of Nasolacrimal duct block in chronic dacryocystitis. Bleeding is the most common complications during the surgery which hampers further procedure. The present paper deals in depth with various techniques and modifications adopted to manage it.
Method: In the present study 2386 cases of chronic dacryocystitis were managed by the conventional external DCR surgery.
Result: In cases of mucosal bleeding, re-packing of nose by 4% xylocaine and adrenaline soaked cotton spindle in backward and superior direction to ensure packing in close contact with mucosa of middle meatus. Otherwise an adrenaline swab was applied at the site of bleeding and a pressure was applied for a few minutes or warm packs were applied which invariably stopped the bleeding besides some adjuvant. Bleeding from angular vein and adjoining muscle is prevented by compressing it by haemostatic retractors. In few we had to tie it with catgut. In cases of bony bleeding, Osteotomy of bleeding bone or bone wax is the answer.
Conclusion: Bleeding encountered in patient of chronic dacryocystitis during DCR surgery is usually easily manageable and leads to post-op success.
Keywords: Bleeding, Dacryocystorhinostomy