Advantages of the surgery: no facial skin incision (except for those who have had skin incision surgery or fistula formation), does not affect the appearance, minimally invasive surgery through the nasal approach; essentially a rerouting surgery of the lacrimal duct, which involves separating and cutting the nasal mucosa located in the anterior part of the middle nasal passage, exposing the bony wall of the lacrimal sac and removing it and then cutting the medial wall of the lacrimal sac, thus allowing the lacrimal sac to communicate directly with the nasal cavity and forming a new lacrimal sac-nasal passage. The channel formed is larger, up to 10 mm or more, to meet the lacrimal drainage needs and is not prone to recurrent blockage, thus having a high success rate. Indications for surgery: Age is generally less than 70 years. Large amount of purulent discharge (especially mucus gel-like discharge), trauma combined with nasolacrimal duct fracture dacryocystitis, large lacrimal sac, failure of transdermal lacrimal sac nasal anastomosis, recurrent acute dacryocystitis, ulcerated skin or incision and drainage of pus in the lacrimal sac area, fistula formation, lacrimal sac mucinous swelling, previous surgery for nasal polyps or sinusitis, congenital nasolacrimal duct dysplasia causing dacryocystitis, foreign body in the lacrimal sac, lacrimal sac stones and partial Benign lesions in the lacrimal sac! If there is a more serious nasal disease or fracture, etc. then the nasal disease and fracture need to be treated first! The shortcomings of the surgery: some patients need general anesthesia to prevent bleeding that may affect the operation and intraoperative sneezing! The fracture of the upper and lower jaws causes difficulty in opening the mouth and cannot be operated on by general anesthesia intubation; the cost is about 8000 yuan per eye. Pre-operative examination: pre-operative lacrimal sac imaging is required to determine the size and location of the lacrimal sac. Nasal endoscopy + photos will be performed. Some patients also need orbital CT (coronal scan + plain scan). Acute onset patients need to control inflammation first! Pre- and post-operative preparation: nasal hair clipping is required before surgery. Tear duct irrigation, anterior nostril filling; intraoperative hemostasis of the mucosa with a semiconductor laser; postoperative filling of the bone window with a tumescent hemostatic sponge with D&G ophthalmic ointment; postoperative removal of the filling after 2-3 days; postoperative blood in the nose may occur within 1-2 months and regular review is required. Postoperative follow-up and endoscopic removal of scabs, clots, granulation tissue, etc. are required 2-3 times (in the operating room). Occasionally, the dilated hemostatic sponge needs to be replaced to ensure the anastomosis is open (cost about 700 RMB/session), and the patient should go home after 1-2 hours of observation on the 3rd floor of Building 1, Area 2 (some patients need to remove the hemostatic sponge filled in the nasal cavity). Tear duct irrigation: it is started 1 day after surgery and the lacrimal duct irrigation needle is flushed in the direction of the middle nasal passage. Post-operative check-ups will be performed at 1 week, 2 weeks, 1 month, 2 months and 3 months, ask the follow-up physician for details. If it is a holiday or menstrual period, the review will be postponed. After surgery, you can sneeze to expose the prosthetic tube in the nostril, and then gently pull out the exposed tube in the front nostril by yourself in front of the mirror, and then use a cotton swab or small finger to insert it back into the nostril after cleaning. If the tube is not exposed, there is no need to do so! If you need to remove the tube, it should be done after the anastomosis is completely epithelialized (about 2-3 months). Unless there is rejection of the prosthetic tube, infection, tearing of the lacrimal punctum, increased secretion, and the prosthetic tube comes out on its own and cannot be reset. Postoperative medication: nasal spray medication: nortone (plus 1ml of compound neomycin ophthalmic solution mixture) should be made back to the aspiration action when spraying. Tear irrigation medication: cotrimoxazole ophthalmic solution and chymotrypsin ophthalmic solution; eye drops medication: colistin ophthalmic solution (or Tobias ophthalmic solution) and chymotrypsin ophthalmic solution, 4 times/day. Bring all medications for each review! (Generally, the medication should be used for about 4-6 weeks, depending on the condition) Success rate of surgery: Because dacryocystitis is not only a disease of the eye, but also closely related to nasal sinus disease and affects the efficacy, it cannot be cured in all cases, especially the post-operative review is crucial! If you don’t review your dacryocystitis on a regular basis, it will significantly affect the outcome! The success rate of the first operation is about 95% or more as reported internationally and by our hospital. Possible postoperative complications: postoperative lacrimation, recurrence of obstruction, and even recurrent flow of pus may occur.