A novel stenting technique in endoscopic dacryocystorhinostomy

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Surgical Innovation

Background:

• Chronic epiphora due to postsaccal stenosis often requires dacryocystorhinostomy (DCR).
• Traditional silicone tube insertion in DCR can be invasive and associated with complications.
• Evaluating alternative stenting methods is crucial for improving patient outcomes.

Purpose of the Study:

• To assess the clinical efficacy of a modified T-tube in endoscopic dacryocystorhinostomy (EDCR).
• To compare the outcomes of modified T-tube insertion versus standard silicone tubes.
• To determine the safety and practicality of the modified T-tube technique.

Main Methods:

• A prospective case series involving 22 patients with postsaccal stenosis undergoing EDCR.
• Modified T-tube placement using a less traumatic endonasal endoscopic technique, avoiding canalicular passage.
• Postoperative evaluation at 1, 3, 6, and 12 months via endoscopic controls, irrigation, and nasal endoscopy.

Main Results:

• An 82% success rate was achieved, defined by the resolution of epiphora and a patent ostium at 12 months.
• Re-stenosis occurred in only four cases (18%) postoperatively.
• One case of granulation tissue formation was noted, without functional impairment.

Conclusions:

• Modified T-tube placement in EDCR is a practical, less traumatic, and potentially cost-effective alternative.
• The technique demonstrates significant clinical efficacy in resolving chronic epiphora.
• This method offers a valuable option compared to traditional canalicular stenting.