An osteotomy is done in the ascending process of maxilla and lacrimal bone
and exposes nasal mucosa.
After removal of the tumour, corresponding lacrimal bone
and frontal process of maxilla were drilled with formation of a round-shaped window 1cm in diametre until the medial wall of the lacrimal sac was exposed.
The lacrimal bone
is larger, longer and thicker in Geococcyx (Figures 9 and 14) than in other species.
It also articulates with the ethmoid bone, the lacrimal bones
and the sphenoid bone.
The maxillary line bisects the lacrimal sac such that the frontal process of maxilla covers anterior half of the sac and thin lacrimal bone
covers the posterior half.
Frontal process of maxilla unites superiorly to the orbital process of the frontal bone, ventrally to the nasal bone and dorsally to the lacrimal bone
(Sicher, Testut & Latarjet and Orts-Llorca; Parkes et al.
The convex anterior margin ascends to the lacrimal bone
and in some patients to the skull base or the lamina papyracea, remaining in contact with the bony lateral nasal wall.
3,4) Clinically orbital cellulitis begins with progressive pain at the level of lacrimal bone
followed by reddening of skin and subsequent progressive oedema of eyelids.
It is attached to the perpendicular process of the palatine bone and the ethmoid process of the inferior turbinate inferiorly, and it ascends to the lacrimal bone
, skull base, lamina papyracea, and middle turbinate superiorly.
OPERATIVE TECHNIQUE: Nasal cavity was packed with 4% xylocaine with adrenaline, prior to surgery; infiltration given with 2% xylocaine with adrenaline, 1X1cm incision was given anterior to uncinate process and flap elevated, lacrimal bone
overlying the sac was removed with kerrisons punch forceps, lacrimal sac visualized and medial wall of sac exposed and the same was incised, mucopurulent or purulent discharge came out and medial wall of sac was removed.