Widths of the LF in its upper, middle, and lower third: Distance between the anterior lacrimal crest
and the posterior lacrimal crest in the upper, middle, and lower third of the LF (Fig.
If medial canthoplasty was performed first, the titanium microscrew might be pull away from the anterior lacrimal crest
during the procedure of CDCR, leading to medial telecanthal deformities again.
The surgery was performed under local anaesthesia; 2% Lignocaine with 1:200000 adrenaline was injected at the junction of the inferior orbital margin with the beginning of the anterior lacrimal crest
and subcutaneously in the medial canthal area.
Because it is generally not possible to effectively palpate the anterior lacrimal crest
in a case of severe nasal bone fracture, an estimate of its position was made, based on the position of the medial canthus.
The lacrimal fascia is incised 1 mm lateral to the anterior lacrimal crest and the bony attachment of the medial canthal ligament was divided with a blunt dissector the sac was separated from the lacrimal fossa.
The periosteum overlying and medial to the anterior lacrimal crest was exposed and elevated with the help of Traquair's periosteal elevator.
For male skulls, when different skull classes were compared, there was significant difference in the distance between nasomaxillary suture and anterior lacrimal crest. For female skulls, when different skull classes were compared, there was significant difference in the length of nasomaxillary suture (lateral height of the nose) and width of nasal bones (width of nasal dorsum).
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.) at the anterior lacrimal crest (Orts-Llorca and Lavine et al., 1979).
The incision is curvilinear incision of about 10-12 mm in length, 3-4 mm from the medial canthus along the anterior lacrimal crest
. Blunt dissection is carried on to reach the periosteum.
After exposing the anterior lacrimal crest
, periosteum was incised with periosteum elevator.
The Toti's procedure is an alternative to DCR surgery in which the medial wall of lacrimal sac is excised, lacrimal fossa and anterior lacrimal crest
A curvilinear incision of 10-15 mm length was made along the anterior lacrimal crest
starting 3 mm above the level of medial palpebral ligament and 3mm medial to medial canthus.