Increased Concomitant Nasal Procedure Frequency in Bilateral Endoscopic Dacryocystorhinostomy

Area of Science:

• Otolaryngology
• Ophthalmology
• Rhinology

Background:

• Primary nasolacrimal duct obstruction (NLDO) etiology is often unknown, with bilateral cases occurring less frequently.
• Dacryocystorhinostomy (DCR) is the standard surgical treatment for NLDO.
• Concomitant nasal pathologies may negatively impact DCR surgical success rates.

Purpose of the Study:

• To retrospectively assess the frequency of concomitant nasal surgical procedures needed for endoscopic DCR.
• To compare the rates of required nasal surgeries in patients with bilateral versus unilateral NLDO.

Main Methods:

• Retrospective analysis of 28 patients undergoing bilateral endoscopic DCR and 30 patients undergoing unilateral endoscopic DCR.
• Recording of all concomitant nasal surgical procedures performed during DCR.
• Analysis of procedure frequencies including septoplasty, turbinectomy, and concha resection.

Main Results:

• A significantly higher rate of concomitant nasal surgery was observed in the bilateral DCR group (78.6%) compared to the unilateral DCR group (26.7%).
• Specific procedures like septoplasty were more frequent in bilateral NLDO patients (57.1%) than unilateral (16.7%).
• Nasal pathologies requiring surgical intervention were more prevalent in patients with bilateral NLDO.

Conclusions:

• Patients with bilateral NLDO exhibit a substantially higher incidence of nasal pathologies requiring surgical intervention during DCR.
• Preoperative assessment of nasal conditions is crucial for optimizing surgical outcomes in NLDO patients, particularly those with bilateral disease.
• Endoscopic DCR in bilateral NLDO often necessitates concurrent nasal procedures, impacting surgical planning and potentially success rates.