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Mechanical endonasal dacryocystorhinostomy with mucosal flaps.
1Department of Ophthalmology, Flinders Medical Centre and Queen Elizabeth Hospital, Adelaide, South Australia. Ophthalmology@fmc.sa.gov.au
The British Journal of Ophthalmology
|December 19, 2002
Summary
This study shows mechanical endonasal dacryocystorhinostomy (MENDCR) is effective for treating nasolacrimal duct obstruction. The MENDCR technique achieved a 95% anatomical success rate, offering a viable alternative for patients.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
Background:
- Nasolacrimal duct obstruction causes epiphora and mucocele.
- Traditional dacryocystorhinostomy (DCR) can be performed externally or endonasally.
- Endonasal techniques aim for less invasiveness with comparable efficacy.
Purpose of the Study:
- To describe and assess the efficacy of a novel mechanical endonasal dacryocystorhinostomy (MENDCR) technique.
- To evaluate the anatomical patency and symptom resolution following MENDCR.
- To compare MENDCR outcomes with existing DCR approaches.
Main Methods:
- A prospective, non-randomized interventional case series of 104 MENDCR procedures.
- Patients with nasolacrimal duct obstruction and no prior lacrimal surgery were included.
- The technique involved creating a large rhinostomy and utilizing mucosal flaps, with follow-up via nasoendoscopy and syringing.
Main Results:
- The study included 104 DCRs in 86 patients (mean age 59 years).
- Overall surgical success was 89%, with an anatomical patency rate of 95%.
- Septoplasty was required in 46% of cases, and 12.5% needed additional endoscopic surgery.
Conclusions:
- MENDCR, featuring a large ostium and mucosal flaps, demonstrates high anatomical success (95%).
- This efficacy is comparable to external DCR and superior to other endonasal methods.
- The technique's success is attributed to the large ostium and preserved mucosal flaps.