Indication

CAREFUL INITIAL PROBING IN THE OPERATING ROOM IS PARAMOUNT FOR A PROPER USE OF THE MASTERKA.

 

Preliminary lacrimal exploration by probing is essential , allowing the surgeon to :

1) Identify the location and severity of the obstruction; 

2) Avoid potential submucosal and false passages;

3) Choose the appropriate Masterka length.

 

 

 

(1)       Tactile exploratory probing also helps the surgeon distinguish simple nasolacrimal duct stenosis from more complex obstructions. The probe was moved inferiorly until a popping sensation was noted (Hasner’s membrane) and then the nasal floor was reached.

 

 

 

(2)       A larger lacrimal probe with a blunt tip is advanced very carefully beneath the inferior turbinate searching for metal-to-metal contact in order to confirm that the Masterka stent is properly placed.

 

 

If metal-to-metal contact is not achieved in the nasal fossa, it is possible that a submucosal or false passages may have been created. 

 

To avoid failure, one should re-start the procedure from the beginning.  If the metal-to-metal contact is still not achieved, it is better to change the method of intubation altogether or to postpone the procedure for a later date.

 

 On this basis (simple stenosis  and  positive metal contact confirmation), the surgeon can assess whether the Masterka stent system is appropriate for the specific patient. 

 

 

                (3) The distance between the punctum and and the nasal floor is  measured.

 

 

 

 

 

PRACTICALY :

Choose a Masterka wich the lenght is,

at least,

longer to the distance between

the punctum to the nasal floor.

 

 

 

 

 

video

 

 

 

masterka 2/0http://youtu.be/S7cCIms91xs



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