Related Experiment Video
Updated: Aug 7, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Endoscopic assessment of the dacryocystorhinostomy ostium after endoscopic surgery
Balwinder Singh Mann1, Peter John Wormald
1Department of Surgery-Otolaryngology Head & Neck Surgery, Adelaide and Flinders Universities, South Australia, Australia.
Objectives:
Dacryocystorhinostomy (DCR) is currently regarded as the treatment of choice for treatment of epiphora resulting from blockage at the level of the nasolacrimal duct. There has been debate on the effect of healing on the size of the DCR ostium after surgery. The aim of this study is to determine how the size of the surgically created lacrimal ostium changes over time.
Study Design:
The authors conducted a prospective cohort study of unselected patients who underwent DCR from March 1999 to November 2004.
Methods:
Thirty-eight patients who underwent intranasal DCR were analyzed. There were 14 males and 24 females with 11 patients undergoing bilateral DCR, resulting in 49 endoscopic intranasal DCRs being analyzed. The endoscopic findings of the size of the ostia were recorded at the time of surgery and at 4 weeks, 6 months, and 12 months after surgery. There were 33 DCRs reviewed at 12 months and 16 reviewed at 6 months who did not reattend for their 12-month appointment. Analysis of variance was used to compare the difference in the ostium sizes at the end of surgery and at 4 weeks, 6 months, and 12 months after surgery.
Results:
The male to female ratio was 1:1.7 and the average age was 64.5 (standard deviation [SD]=17.8 years). The ostium measured 11.8 (STD=2.3, 95% confidence interval [CI]=11.1-12.5)x7.2 (SD=1.7; 95% CI=6.7-7.7) at the time of surgery and 10.1 (SD=2.3; 95% CI=9.3-10.9)x6.4 (SD=1.3; 95% CI=6.0-6.9) at 4 weeks, 9.8 (SD=2.5; 95% CI=9.0-10.6)x6.5 (SD=1.5; 95% CI=6.0-6.9) at 6 months, and 10.1 (SD=2.5; 95% CI=9.2-11.0)x6.6 (SD=1.6; 95% CI=6.0-7.1) at 12 months. Statistical analysis (analysis of variance) showed a significant shrinkage from surgery to 4 weeks but no statistical difference from 4 weeks to 6 or 12 months.
Conclusion:
The DCR ostium shrinks a small but significant amount in the first 4 weeks after surgery. Thereafter, the ostium size appears to be stable. We propose that the surgical technique used in which the nasal and lacrimal mucosa is approximated results in a first intention healing with minimal ostial granulation tissue and stenosis and minimal shrinkage of the postoperative DCR ostium.
Related Concept Videos
01:21Tracheostomy Decannulation
Description of the Procedure
Decannulation refers to the permanent removal of the tracheostomy tube, signaling the resolution of the condition that initially necessitated the tracheostomy. The process requires a well-coordinated interplay between...
01:24Ostomy Care
An ostomy is a surgical procedure that creates an artificial opening from the intestines to the outside of the body, allowing for the rerouting of effluent. This opening is known as a stoma. A stoma usually protrudes above the skin surface, appearing pink or red, moist, and round, and it lacks nerve sensations.
There are different types of ostomies, including colostomies, ileostomies, and urostomies:
01:29Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
01:29Suctioning the Nasopharyngeal Airway
Equipment Required
01:26Endoscopic Studies II: Thoracocentesis
Description
Excess pleural fluid or air may accumulate in some respiratory disorders in the thoracic cavity. To treat pleural effusion, a physician conducts thoracentesis by carefully piercing the chest wall and entering...