Endonasal endoscopic dacryocystorhinostomy: our experience

*, Deviprasad D and *, Mahesh S. G. and Pujary, K. and Pillai, S. and *, Mallick S. A. and Jain, V. (2009) Endonasal endoscopic dacryocystorhinostomy: our experience. Indian J Otolaryngol Head Neck Surg, 61. pp. 223-226.

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Objectives To study the outcome of endonasal endoscopic dacryocystorhinostomy (DCR) with or without mucosal fl ap preservation, without mitomycin local application, silicon tube stenting or laser assistance. To determine the duration of the surgical procedure of DCR, infl uence of simultaneously performed endonasal endoscopic procedures for concomitant sinonasal diseases. Methods Combined retrospective and prospective study in our tertiary referral center. 24 patients with chronic dacryocystitis underwent 25 standard endonasal endoscopic DCR procedures, 10 with and 15 without mucosal fl ap preservation. 6 of these had concomitant sinonasal diseases for which they underwent septoplasty or functional endoscopic sinus surgery (FESS) or both, simultaneously or as staged procedures. Relief from epiphora and patency of the nasolacrimal fi stula was assessed by nasal endoscopy and syringing of the lacrimal apparatus at 1 week, 3 weeks and 3 months postoperatively. Results Out of 18 patients who underwent only DCR, 17 patients (94.44%) had complete relief from epiphora. Out of 6 patients who underwent 7 DCRs with concomitant sinonasal surgery, 5 patients (85.71%) had complete relief from epiphora. Overall 23 out of 25 DCRs (92%) had complete relief. In 15 of the 25 procedures, mucosal fl ap was excised completely. In remaining 10 procedures, fl ap was trimmed, repositioned to cover exposed bone around the newly created nasolacrimal fi stula. In either situation, only one patient each had partial block of the nasolacrimal fi stula. Average duration of the surgical procedure of DCR was 18 min. Conclusion Endonasal endoscopic DCR is a viable alternative to external DCR, co-existing sinonasal diseases can be managed simultaneously, as may be required in 25% of cases. It can be performed under 20 min without mucosal fl ap preservation, mitomycin local application, silicon tube stenting or laser assistance and can still provide a good success rate (92%) with less complications.

Item Type: Article
Uncontrolled Keywords: Epiphora Endoscopic dacryocystorhinostomy DCR Mucosal fl ap
Subjects: Medicine > KMC Mangalore > Surgery
Medicine > KMC Mangalore > E.N.T
Depositing User: KMCMLR User
Date Deposited: 08 Feb 2014 11:13
Last Modified: 08 Feb 2014 11:13
URI: http://eprints.manipal.edu/id/eprint/138720

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