West Operation

WEST OPERATION (West, more correctly West), a surgical method proposed by West in 1910 for chronic diseases of the lacrimal sac caused by dacryostenosis (in dacryocystitis, dacryocystocele, lacrimal fistulas, phlegmon, etc.), and distinguished by the fact that it allows opening the lacrimal sac from the nasal cavity side, bypassing the nasolacrimal duct and approaching the sac above any strictures. Simultaneously with West, through the work of Halle and Polyak in more than 2,000 cases, it was established that this endonasal operation restores the physiological function of the lacrimal drainage apparatus in more than 90% of cases. The operation is performed as follows: after smearing the nasal mucous membrane with a 20% solution of cocaine with adrenaline, in front of the anterior end of the middle turbinate, a rhomboid flap of mucous membrane is separated from the bone, and thus the bony wall of the lacrimal sac area is exposed. Having turned the flap downward, a window is made in the os lacrymale—the inner wall of the lacrimal sac is opened, which is grasped with hooks and resected with a conchotome. The mucous membrane is held with a tampon for 1-2 days. After healing, tears flow into the nose through the artificial opening.