Middle Turbinate Attachment locating Common Canaliculus During an EndoscopicDacryocystorhinostomy

: Objective: To determine whether anterior middle turbinate attachment (MTA) to the lateral wall of the nose can serve as a reliable endoscopic landmark for the approximate level of the common canaliculus of the lacrimal sac during endoscopic dacryocystorhinostomy (DCR). Method and Materials: This descriptive anatomical study included 12 cadaveric heads and 24 endoscopic DCRs. After performing DCR, the location of the common canaliculus was measured endoscopically relative to the MTA. Results: The mean location of the common canaliculus was 1 mm below MTA. The common canaliculus was found at, below, and above the MTA level in 42%, 50%, and 8% of the specimens, respectively. The common canaliculus was identified up to 4 mm below and 1 mm above the MTA level on all specimens and sides. Conclusion: MTA can be used as a reliable anatomical landmark to predict the location of the common canaliculus during endoscopic DCR.