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Endonasal dacryocystorhinostomy with mucosal flaps
Angelo Tsirbas1, Peter J Wormald
1Department of Ophthalmology, Flinders Medical Centre and Queen Elizabeth Hospital, Adelaide, South Australia, Australia. ophthalmology@fmc.sa.gov.au
American Journal of Ophthalmology
|December 31, 2002
Summary
This study introduces a new endonasal dacryocystorhinostomy (DCR) technique, achieving a 91% anatomic success rate. The procedure, involving a large ostium and mucosal flaps, offers comparable results to other DCR methods.
Area of Science:
- Ophthalmology
- Otolaryngology
- Surgical Innovation
Background:
- Naso-lacrimal duct obstruction (NLDO) causes significant epiphora and mucocoele.
- Endonasal dacryocystorhinostomy (DCR) is a surgical treatment for NLDO.
- Evaluating novel surgical techniques is crucial for improving patient outcomes.
Purpose of the Study:
- To describe a novel endonasal dacryocystorhinostomy (DCR) technique.
- To assess the efficacy and success rates of this new DCR method.
Main Methods:
- Prospective nonrandomized interventional case series of 44 endonasal DCRs.
- New technique: creation of a large bony ostium and mucosal flaps for anastomosis.
- Inclusion criteria: symptomatic, clinical, and radiologic NLDO; exclusion: prior lacrimal surgery.
Main Results:
- 44 endonasal DCRs performed on 36 patients (average age 62.9 years).
- Anatomic success (patent nasolacrimal system) achieved in 91% (40/44) of operations.
- Symptomatic and anatomic success in 89% (39/44); 5 DCRs classified as failures.
Conclusions:
- The new endonasal DCR technique, featuring a large ostium and mucosal flaps, demonstrates high efficacy.
- Success rates (91% anatomic) are comparable to existing endonasal and external DCR techniques.
- Experience in endoscopic nasal surgery is beneficial for optimal outcomes in endonasal DCR.