Conjunctivorhinostomy with rubber-tipped Jones tube.

One of the problems of conjunctivorhinostomy that employs the conventional Jones tube is that the end of Jones tube has to be manipulated by the surgeon so that the tube resides within the nasal cavity while not touching the middle turbinate and the nasal septum. As a result, patients who have high nasal septal deviation, paradoxical curvature, or middle turbinate hypertrophy have inadequate space in the nasal cavity for the Jones tube to rest. Such patients required either septoplasty or turbinectomy prior to conjunctivorhinostomy. To overcome such a problem, the authors connected a 4 French rubber tube to the tip of the Jones tube and helped the end of the tube to reside within the nasal cavity regardless of the anatomic variation of nasal septum or the middle turbinate. When such modified procedure is used, the Jones tube makes good contact with the conjunctiva, lacrimal sac, and the nasal mucosa while the rubber tube remains afloat within the nasal conjunctiva. Such modification helps the tube to reside within the nasal cavity without foreign body reactions and granulation tissue complications, and there is no need to change tubes to make up for the loss of tube length because of postoperative tissue contracture. Between April 2000 and August 2001, the authors performed conjunctivorhinostomy with a rubber-tipped Jones tube on 8 patients with drainage problems of the nasolacrimal duct system and obtained satisfactory results without complications.