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A method of securing double silicone tube intubation of the lacrimonasal system.

To the Editor. —Several recent articles1-3offered solutions to the complication of displacement of the silicone tubing loop in double intubation of the lacrimonasal system. Displacement of the silicone tube loop into the lacrimal sac creates a surgical dilemma with no good or easy solution. This complication can be prevented by securing the loop with a segment of silicone sponge rod 5 mm in diameter. This technique has two additional advantages: (1) It makes it easy to adjust the length of the loop for the best fit. (2) It facilitates the removal of the tubing at the end of the intubation period by making it easy to localize, visualize, and grasp the nasal end of the tubing for extubation. To secure the tubing loop, simply push the two probes, with tubing still attached, through a 1-cm length of sponge (Fig 1). After determining the proper length and tension, tie