Image-Guided Dacryolocalization (IGDL) in Traumatic Secondary Acquired Lacrimal drainage Obstructions (SALDO).

Objective: The aim of this study was to illustrate the usefulness of stereotactic or image-guided navigation in the management of traumatic secondary acquired lacrimal drainage obstructions.

Methods: Image-guided dacryolocalization was performed on 3 patients. All the patients were posttraumatic nasolacrimal duct obstruction as a consequence of gross naso-orbito-ethmoid fractures. All the procedures were performed through an endoscopic endonasal approach using the intraoperative electromagnetic image-guided Fusion ENT navigation system. Intraoperative anatomical guidance in localizing the lacrimal drainage system, usefulness at crucial phases of surgery, ease of surgery, and complications were noted.

Results: All patients underwent a powered endoscopic dacryocystorhinostomy using standard protocols but with an additional intraoperative navigation use at each of the major steps during the surgery. The dacryolocalization provided useful anatomical clues while operating in the vicinity of orbit and skull base. The set up was quick with no additional technical difficulties.

Conclusions: Image-guided dacryolocalization is a very useful adjunctive tool that facilitates safe and precise surgeries in otherwise challenging surgical situations.