Fig. 20. Placement of dacryocystorhinostomy anterior to the tip of the middle turbinate as viewed inside of nose (A) and as viewed externally straddling the anterior lacrimal crest (B). The configuration of the sac and nasal mucosal flaps used by the authors is shown. A large posteriorly hinged nasal mucous membrane flap that is not sutured but splinted with a catheter and an anteriorly hinged lacrimal sac flap is used.