A mixture of epinephrine and hyaluronidase, injected into the naso-orbital recess at the start of dacryocystorhinostomy and into the nasal mucosa immediately after bone penetration, appears to have a greater hemostatic effect than epinephrine alone. Surgical time is shortened by the reduced need for angular vessel ligation, suction, cautery of bleeding, and nasal packing. Postoperative ecchymosis and nasal clotting are also reduced.
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