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Related Experiment Video

Updated: Jun 16, 2026

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
07:30

Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction

Published on: October 13, 2017

Experience with endoscopic dacryocystorhinostomy using four methods.

Chris de Souza1, Jayesh Nissar

  • 1ENT and Skull Base Surgery, Tata Memorial Hospital, Lilavati Hospital and Holy Family Hospital, Mumbai, India. christ@mtnl.net.in

Otolaryngology--Head and Neck Surgery : Official Journal of American Academy of Otolaryngology-Head and Neck Surgery
|February 23, 2010
PubMed
Summary

Endoscopic dacryocystorhinostomy (EDCR) using silastic stents or medial wall excision of the lacrimal sac (LS) offers high success rates for chronic dacryocystitis. Other methods like incision and drainage or grommets show significantly higher failure rates.

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Area of Science:

  • Ophthalmology
  • Surgical Techniques
  • Rhinology

Background:

  • Chronic dacryocystitis presents a significant challenge in nasolacrimal duct obstruction.
  • Endoscopic dacryocystorhinostomy (EDCR) is a minimally invasive surgical approach.
  • Evaluating different EDCR techniques is crucial for optimizing patient outcomes.

Purpose of the Study:

  • To compare the efficacy of four distinct endoscopic dacryocystorhinostomy (EDCR) methods.
  • To identify the most successful EDCR techniques for treating chronic dacryocystitis and associated epiphora.

Main Methods:

  • A retrospective case series involving 1450 patients undergoing EDCR.
  • Four techniques were analyzed: incision and drainage, grommet insertion, silastic lacrimal stents, and medial wall excision of the lacrimal sac (LS).

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  • Success was defined by resolution of epiphora, absence of dacryocystitis attacks, and fistula patency.
  • Main Results:

    • Incision and drainage (65% failure) and grommet insertion (68% failure) demonstrated high failure rates.
    • Silastic lacrimal stents achieved success in all patients while in situ, though some required removal due to complications.
    • Medial wall excision of the LS had a low failure rate (1.4%), with success associated with clear sac or mucus findings.

    Conclusions:

    • Silastic lacrimal stents and medial wall excision of the lacrimal sac (LS) are the most effective EDCR methods.
    • Excision of the LS medial wall offers comparable success to stenting without the risk of corneal opacities.