Limited nasal septoplasty by ophthalmologists during endonasal dacryocystorhinostomy: is it safe?

Significant deviated nasal septum (DNS) may preclude the performance of endonasal dacryocystorhinostomy (DCR). The purpose of this study was to investigate the outcomes of limited nasal septoplasty in tackling signficant DNS performed by trained ophthalmologists during endonasal DCR.

In this retrospective interventional case series, the records of all patients requiring limited nasal septoplasty for significant DNS during endonasal DCR at 2 tertiary ophthalmic centers in Hong Kong during January 2006 to December 2007 were reviewed. Surgical outcomes, demographic factors, and intraoperative and postoperative details were recorded and analyzed.

A total of 25 septoplasties were performed in 25 patients (total of 28 DCR). After the nasal septoplasty, all nasal cavities had better exposure of the surgical site allowing completion of the endonasal DCR. At the latest follow-up, the anatomical and functional success rates of the endonasal DCR were both 96.4% (27/28). In one patient, septoplasty was complicated by asymptomatic mucosal adhesion between the lateral nasal wall and the nasal septum.

In the hands of trained ophthalmic lacrimal surgeons, limited nasal septoplasty is an effective and safe procedure during endonasal DCR, allowing better exposure of the surgical field in patients with significant DNS.