• Used for non-surgical closure of nasal septum perforations
• Minimises the risk of crusting, epistaxis and other complications following septum perforations
• Can easily be customized by the surgeon
• One-piece, Ø 32 mm

• Material: silicone
• Supplied sterile, individually pouched

Post-operative stenoses may spoil successful recanalization of the lacrimal duct. A silicone space retainer prevents this, but placing a stent inside the narrow lacrimal duct can be difficult.

The bess Lacrimal Duct Stent with integrated probes facilitates the placement of the silicone space retainer in the lacrimal duct.

The bess Lacrimal Duct Stent comes with a separate Space Retainer for the lacrimal sac. It fixes the ends of the silicone Lacrimal Duct Stent and protects the bone fenestration from closure by granulation tissue.

The ends of the silicone Lacrimal Duct Stent are inserted in the Space Retainer by means of a special Inserter.

After placement, the Space Retainer is secured against displacement by a clip. Parts of the Lacrimal Duct Stent jutting over into the nasal meatus can be shortened with scissors.

• two probes for access through the lower and upper lacrimal point
• flexible yet stable probes
• no bulging in the place the silicone stent is fixed to the probe
• gold-plated metal probes for maximum biocompatibility
• one size fits all
  
  

Device to elevate fragments in nasal bone and zygomatic arch fractures.

The Behrbohm / Kaschke elevator was developed for the atraumatic and effective repositioning of nasal bone fractures.
The form of the branches corresponds to that of the inner nasal cavity.
The elevator is inserted via the floor of the nose and then carefully moved from caudal to cranial. Dislocated fragments are thus elevated and atraumatically brought into their original position. The repositioning of comminuted fractures of the nasal septum, or of the perpendicular plate and of the vomer bone is managed via the even surface.
The pair design enables the surgeon to correct and stabilize bones and cartilage fragments with counter-pressure on both sides, whereby the bayonet-shaped design excludes any interference during parallel use.
The double-ended design provides two sizes.
Centimetre graduation renders it possible to determine how deeply the device was inserted.
The device is also successfully applied in the elevation of impressed fragments of the zygomatic arch: Via a skin incision of approx. 15mm above the temporal fossa, it is advanced subfascially from cranial to caudal below the zygomatic arch, repositioning the impressed fragments by elevating.
We thank Prof. Dr. Hans Behrbohm of the Park Clinic in Berlin-Weissensee, and Prof. Dr. Oliver Kaschke of St.Gertrauden Hospital in Berlin-Wilmersdorf, for their ideas and scientific monitoring.

• Material: stainless steel
• Supplied in a set containing one instrument for the right side and one instrument for the left side

In many cases, it is difficult to successfully reposition and stabilise extensive repositioned orbital floor fractures exclusively by means of an infraorbital access.
The alloplastic materials frequently applied in the last few years must either be removed in a time-consuming operation, or implanted permanently with a risk of late complications. Applying the Salzburg maxillary sinus endothesis makes it possible to dispense with alloplastic materials.
As a result of its anatomical shape and a range of different sizes, the maxillary sinus endothesis is a perfect fit with which an ideal reconstruction of the orbital floor can be achieved.

Elevation and lowering of the orbital floor via the filling volume of the endothesis can also be effected postoperatively, thus achieving optimum Hertel values.  This is, for example, not possible postoperatively if tamponade strips are used. Their use following the absorption of an orbital haematoma and oedema can result in a defective position of the ocular globe, an effect which is even more enhanced after the tamponade has been removed.

Maxillary sinus endotheses have been used very successfully for more than 20 years at the University Clinic Salzburg. Extensive experience and documentation are available regarding its application.

Indication

Dislocated simple or complex orbital floor fractures

• In the case of unstable repositioning of the orbital floor fragments

• In the case of massive comminuted maxillary sinus wall fractures with the aim to anatomically reposition pedunculated periosteal fragments, but also free and small local fragments

• In the case of comminuted middle face fractures with circular, multiple maxillary sinus wall fractures

Application

The evacuable Salzburg maxillary sinus endothesis is applied in the treatment of dislocated simple and complex orbital floor fractures. Following the revision of the orbital floor infraorbitally, the endothesis is inserted via a second surgical access through the facial maxillary sinus window into the maxillary sinus using the enoral approach, and filled with contrast medium by means of a filling tube/drain. This drain runs from the maxillary sinus through a surgically constructed window in the lower nasal passage, where it exits. The endothesis is removed via the nasal window after a period of 4 weeks.

Conditional contra-indications

• Extreme exophthalmos due to swelling and bleeding. If an endothesis is placed and immediately filled completely, the danger of excessive pressure on the eye may cause loss of eyesight.

• Surgical procedure in childhood due to highly positioned cuspid germs which do not allow the construction of a facial maxillary sinus window.

• Acutely inflamed sinuses

Advantages

Compared to other conventional methods, the Salzburg endothesis offers the following advantages:

• Anatomically optimal design
• Different, side specific sizes
• Simple removal
• Postoperative adjustment possible
• No second surgical intervention required for its removal