Meet the Lacrimal Sac: Endoscopic Surgeons’ Road Map

Amit Kumar Tyagi*, Mary Kurien, Aparna Irodi, Ajoy M. Varghese, Sunil J. Holla, Regi Thomas

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

1 Citation (Scopus)


Knowledge of lateral nasal wall landmarks in relation to lacrimal apparatus is essential for successful endoscopic dacryocystorhinostomy. This descriptive study of right and left sagittally sectioned ten adult cadaver head specimens was done measuring various lateral nasal wall anatomical landmarks including lacrimal apparatus with digital calipers. Maxillary line was identified in 75%, majority overlapping lacrimal sac. Genu of middle turbinate was at or posterior to nasolacrimal duct. Mean distance of superior end of sac was 8.88 mm above axilla, between its anterior edge and axilla was 10.58 mm and its length was 11.72 mm. Considering above measurements, ‘Rule of 10’ can be applied for nasal mucosal incision. A “Three Tier Approach” to overcome mucosal (nasal), bony (lacrimal and frontal process of maxilla) and mucosal (sac) boundaries exposes lacrimal sac up to its inferior limit ensuring successful endonasal endoscopic dacryocystorhinostomy.

Original languageEnglish
Pages (from-to)18-24
Number of pages7
JournalIndian Journal of Otolaryngology and Head and Neck Surgery
Issue number1
Publication statusPublished - Mar 2021


  • Cadaver
  • Dacryocystorhinostomy
  • Lacrimal apparatus
  • Lacrimal apparatus diseases
  • Nasolacrimal duct

ASJC Scopus subject areas

  • Surgery
  • Otorhinolaryngology


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