Endoscopic dacryocystorhinostomy: outcomes using mucosal flap preserving technique

Area of Science:

• Ophthalmology
• Otorhinolaryngology

Background:

• Transnasal endoscopic dacryocystorhinostomy (EDCR) is a common treatment for chronic dacryocystitis.
• Restenosis of the surgical site is a primary cause of EDCR failure, reducing success rates.

Purpose of the Study:

• To evaluate the long-term efficacy of EDCR employing a large bony ostium, preserved mucosal flaps, and silicone tube intubation (STI).
• To assess the potential of this modified EDCR technique to minimize granulation tissue and synechiae formation, thereby reducing restenosis.

Main Methods:

• A retrospective analysis of 126 patients who underwent EDCR between January 2004 and March 2009.
• Surgical technique involved creating a large bony ostium, preserving nasal and lacrimal mucosal flaps, and stenting the new ostium with a silicone tube.

Main Results:

• The study achieved a high surgical success rate of 93% with the described EDCR technique and STI.
• The method demonstrated effectiveness in preventing restenosis, indicated by the high success rate and preservation of mucosal flaps.

Conclusions:

• EDCR with mucosa preservation and STI is a safe and effective procedure for chronic dacryocystitis, with low complication rates.
• Creating a large bony ostium and preventing restenosis are crucial for surgical success. This technique is recommended as an alternative for chronic dacryocystitis.