[Endoscopic dacryocystorhinostomy with mucosal flap]

Dacryocystorhinostomy (DCR) is done commonly in subjects with chronic dacryocystitis and nasolacrimal duct stenosis, and endoscopic DCR is now an established alternative to external approaches. Mucosal preservation is important in preventing granulation tissue and synechia from forming around the ostium. Our modified endoscopic DCR using a mucosal flap involves creating a large bony opening to form an anastomosis for the lacrimal sac and nasal mucosa. Instead of silicon tubing, we use a silicon sheet to avoid manipulating the canaliculi. Our modifications enable an easy, safe, effective form of DCR easily implemented by otolaryngologists familiar with endoscopic sinus surgery.