Discussion

Careful preliminary lacrimal probing in the Operating Room

is paramount for a proper use of the Masterka.


1) It distinguishes by tactile sense, the more common types of mucosal nasolacrimal stenosis from the less frequently seen cases with complex stenosis.
2) By requiring metal-to-metal contact in the nasal fossa, it avoids submucosale and false passages which will always result in failure.
3) It facilitates the correct choice of stent length which should extend 5 mm beyond the site of nasolacrimal stenosis.
When the masterka is appropriately selected and inserted properly, the complications are minimal and the success rate very high.

 

 

 

 

Optimum results and the prevention of complications depend directly on two elements : expert technique and appropriate selection of the stent length.
If metal-to-metal contact is not achieved in the nasal fossa, it is possible that a submucosal passage 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.
It is also possible that the stent model selected may be too short if the fixation plug of the Masterka is already in the punctum while the stent has not yet reached the site of mucosal stenosis. To avoid failure, a longer stent model should then be utililized.

 

AT LEAST THE MASTERKA LENGHT'S AS TO BE SUPERIOR TO THE DISTANCE BETWEEN THE 'PUNCTUM AND NASAL FLOOR..

 

The Masterka is an excellent alternative for stenting simple congenital nasolacrimal obstructions at any age, whether early or very late.
    • Routine general anesthesia techniques are sufficient.
    • The operating time is similar
    • The MasterKa avoids the unnecessary and often difficult intranasal maneuvers needed to pullout the stent and tubing of traditional "pulled" intubation systems
    • The cost of the Masterka is balanced by a much better success rate, and therefore, fewer repeat procedures.



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