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Abstract
DCR is the operation of choice to relief epiphora due to nasolacrimal duct obstruction. DCRcan be approached by one of three methods, the endonasal approach, the external technique and the transcanalicular approach.
Tje traditional approach since 1890s has been the external (EX-DCR) or transcutaneous route (Toti,1904).
The high failure rate of Totis procedure (1904) encouraged the modifications, Kuhnt (1914) and Ohm (1920) were able to improve the surgical sucess rate by suturing the lacrimal sac mucosa to the periosteum or nasal mucosa. In 1921, Dupuy-Dutemps described a very successful procedure of DCR in which the lacrimal sac was incised, forming anterior and posterior flaps, and then carefully anastomosed to the nasal mucosa.