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Updated: May 17, 2026
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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Endonasal endoscopic dacryocystorhinostomy: our experience
D Deviprasad1, S G Mahesh, K Pujary
1Department of Otorhinolaryngology and Head and Neck Surgery, Kasturba Medical College and Hospital, Manipal, 576 104 Karnataka India.
Summary
Endonasal endoscopic dacryocystorhinostomy (DCR) offers a high success rate (92%) for chronic dacryocystitis, even when performed quickly without additional interventions. This effective procedure can also address simultaneous sinonasal diseases.
Area of Science:
- Ophthalmology
- Otorhinolaryngology
- Surgical Innovation
Background:
- Chronic dacryocystitis often necessitates dacryocystorhinostomy (DCR) to restore nasolacrimal drainage.
- Endonasal endoscopic DCR presents an alternative to external approaches, with ongoing research into optimizing techniques and outcomes.
Purpose of the Study:
- To evaluate the outcomes of endonasal endoscopic DCR without specific adjuncts like mitomycin C, stenting, or laser.
- To assess the impact of preserving or excising the mucosal flap on DCR success.
- To determine the operative time and influence of concurrent sinonasal procedures on DCR outcomes.
Main Methods:
- A combined retrospective and prospective study involving 24 patients undergoing 25 endonasal endoscopic DCR procedures.
- Procedures were categorized by mucosal flap management (preserved vs. excised) and the presence of simultaneous sinonasal surgery (septoplasty, FESS).
- Outcomes, including epiphora relief and fistula patency, were assessed via nasal endoscopy and syringing at multiple postoperative intervals.
Main Results:
- An overall success rate of 92% (23/25) was achieved for epiphora relief.
- Procedures with mucosal flap excision (15/25) and preservation/trimming (10/25) showed similar low rates of partial fistula block (1 patient each).
- The average DCR procedure duration was 18 minutes, with no significant difference noted for concomitant sinonasal surgeries.
Conclusions:
- Endonasal endoscopic DCR is a highly effective and viable alternative to external DCR.
- The procedure can be performed efficiently (under 20 minutes) without specialized adjuncts, achieving excellent success rates.
- Simultaneous management of co-existing sinonasal diseases is feasible and does not compromise DCR outcomes.
