Endonasal dacryocystorhinostomy with mucosal flaps: our experience

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Surgical Innovation

Background:

• Nasolacrimal duct obstruction causes epiphora, impacting quality of life.
• Conventional external dacryocystorhinostomy (DCR) can result in facial scarring and longer recovery.
• Endoscopic DCR presents a minimally invasive alternative with potential cosmetic and functional benefits.

Purpose of the Study:

• To evaluate the efficacy and outcomes of endoscopic dacryocystorhinostomy (DCR) using cold steel instruments.
• To compare the advantages of endoscopic DCR over traditional external DCR approaches.
• To assess the long-term success rate of endoscopic DCR in patients with nasolacrimal duct obstruction.

Main Methods:

• A prospective study included 120 patients with nasolacrimal duct obstruction (Jan 2009 - Jan 2011).
• All patients underwent endoscopic DCR utilizing conventional cold steel instruments.
• Surgical technique involved marsupialization of the lacrimal sac with creation of mucosal and lacrimal flaps.

Main Results:

• Endoscopic DCR procedures were performed as a daycare surgery, with same-day discharge.
• The technique focused on complete exposure and marsupialization of the lacrimal sac.
• Success was defined by resolution of epiphora and patent lacrimal system at 1-year follow-up.

Conclusions:

• Endoscopic DCR is a superior alternative to external DCR, offering cosmetic advantages and reduced bleeding.
• The described technique ensures complete exposure and marsupialization for optimal outcomes.
• Endoscopic DCR provides a highly effective and safe treatment for nasolacrimal duct obstruction.