Nasolacrimal Stent (Bicanalicular)

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Preoperative Considerations


  • Discomfort or pain during and after the procedure.
  • Risk of infection at the insertion site.
  • Irritation or injury to the nasal mucosa or surrounding structures.
  • Migration or displacement of the tube, leading to ineffective tear drainage or discomfort.
  • Granuloma formation around the tube.
  • Need for possible DCR in the future
  • RIsk of eyelid injury, tears


  • Sedation or GA


  • None


  • Mono or bicanalicular nasolacrimal tube (Mini Manoka, Crawford, etc.)
  • Corneal shield with lubrication
  • Lacrimal dilator
  • Lacrimal probes
  • Hemostat/Debakey
  • Scissor
  • Optional
    • Nasal Speculum
    • Fiberoptic Camera
    • 3-0 silk suture


Postoperative Considerations


  • Examine relation of

Follow Up:

Operative Note

Surgeon(s): ***

Assistant Surgeon(s):  ***

Preoperative Diagnosis: ***

Postoperative Diagnosis: Same

Procedure(s): ***

Anesthesia: General

Implants: None


Drains: None

Fluids: See anesthesia record

EBL: Minimal

Complications: None

Counts:  Correct x2

Indications: ​***

Findings: As expected

Procedure in Detail:

The patient was seen in the preoperative holding area with a H&P was updated, consents were verified, surgical site marked, and all questions and concerns related to the proposed procedure were discussed in detail.  The patient was transferred to the operating room by the anesthesia team.  The patient underwent general anesthesia with endotracheal intubation. Tegaderms were placed over the eyes. The patient was prepped and draped in the standard fashion for maxillofacial procedures.  A time-out was performed and the procedure began.

A suitable size of nasolacrimal tube was selected based on preoperative assessment and measurements. The nasolacrimal system from the canaliculi was identified and dilated. The selected nasolacrimal tube was carefully inserted into the proximal end of the nasolacrimal duct, ensuring proper positioning and alignment with the lacrimal drainage system. The distal end of the nasolacrimal tube was advanced into the nasal cavity, allowing for adequate drainage of tears and fluid. The placement of the nasolacrimal tube was confirmed endoscopically, ensuring proper positioning and patency of the lacrimal drainage pathway.

The patient's face was then cleaned and the posterior pharynx was suctioned. An OG tube was used to suction out the contents of the stomach. Tegaderms were removed from the eyes. Dressings were placed. The patient was then transferred back to the care of the anesthesia team for extubation and recovery.


  1. 68810 - Dilation of nasolacrimal duct, with or without irrigation (e.g., balloon dilation), unilateral or bilateral
    • This code is used for procedures involving the dilation of the nasolacrimal duct, which may be performed as part of the stent placement procedure.
  2. 68815 - Probing of nasolacrimal duct, with or without irrigation, unilateral or bilateral
    • This code is used for procedures involving the probing of the nasolacrimal duct, which may also be performed in conjunction with stent placement.
  3. 68840 - Dacryocystorhinostomy (DCR), with or without insertion of tube or stent
    • This code is used for procedures involving the creation of a new drainage pathway for tears from the lacrimal sac into the nasal cavity, which may involve the insertion of a stent.
  4. 68850 - Probing of lacrimal canaliculi, with or without irrigation, unilateral or bilateral
    • This code is used for procedures involving the probing of the lacrimal canaliculi, which may be part of the overall treatment for nasolacrimal duct obstruction.
  5. 68899 - Unlisted procedure, lacrimal system
    • This code is used for procedures related to the lacrimal system that do not have a specific CPT code. It may be used in cases where the procedure performed does not fit the description of any existing code.