Nasolacrimal obstruction in craniofacial surgery

In CF surgery blockage of the nasolacrimal system is sometimes found. Most commonly this is seen in facial clefts and post-traumatic conditions. In this paper an anatomical classification is outlined, which divides the lacrimal passage system into 4 separate parts, each requiring special consideration in the planning of surgical correction. A new technique of transposing the upper punctum and canaliculus into the lower eyelid is also described. This can be used where the lower punctum has been damaged and the upper punctum is intact, but is unable to prevent epiphora.