Air reflux and other sequelae following endoscopic dacryocystorhinostomy

To assess postoperative sequelae of endoscopic dacryocystorhinostomy (endoDCR), including rates of air reflux and other otolaryngologic sequelae.

Patients who underwent endoDCR over a 5-year period were included in a follow-up questionnaire regarding side effects after surgery. The questionnaire included questions regarding tearing, air reflux, and nasal symptoms.

Results were obtained on 82 patients (101 endoDCRs). Most patients were women (70.7%) and white (85.4%). The mean postoperative period was 39.7 months (range 8-66 months). The most common sequela was air reflux from the puncta (46 cases, 45.5%). Of the 82 patients, 58.7% experienced symptoms only "rarely," while 18.5% had symptoms daily. Air reflux was most commonly associated with nose blowing (73.9%). Success of endoDCR correlated with presence of air reflux (p = 0.0044). All patients with air reflux preferred having air reflux to epiphora. Epistaxis was present in 8 cases (7.9%) and nasal congestion in 21.8% of the cases.

Treatment for epiphora with endoDCR results in air reflux in almost half of patients, which is minimally bothersome to patients. The presence of air reflux highly correlates with resolution of epiphora and has a similar incidence in external and endoDCRs.