Comparison between endoscopic and external dacryocystorhinostomy by using the Lacrimal Symptom Questionnaire: A pilot...

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Surgical Innovation

Background:

• Epiphora significantly impacts patient quality of life, often due to nasolacrimal duct obstruction.
• Traditional external dacryocystorhinostomy (DCR) involves a skin incision.
• Endonasal DCR has emerged as a popular alternative due to endoscopic advancements.

Purpose of the Study:

• To prospectively compare the quality of life in adult patients undergoing endonasal versus external DCR for acquired nasolacrimal duct obstruction.
• To evaluate subjective well-being using the validated Lacrimal Symptom Questionnaire (Lac-Q).

Main Methods:

• Adult patients with acquired nasolacrimal duct obstruction were assigned to endonasal or external DCR based on preference.
• The Lacrimal Symptom Questionnaire (Lac-Q) was administered pre- and post-surgery (3 and 6 months).
• Lac-Q scores range from 0 (no concerns) to 33 (maximal symptoms/social impact).

Main Results:

• Sixty patients (22 endonasal, 38 external) were studied.
• Endonasal DCR showed a greater improvement in total Lac-Q scores (12.0 points) compared to external DCR (7.0 points) (p=0.005).
• Endonasal DCR also demonstrated significantly better outcomes in social impact (p=0.029) and lacrimal symptom scores (p=0.014), with higher anatomic patency rates (90.4% vs. 60.0%).

Conclusions:

• Both endonasal and external DCR improve quality of life, as measured by the Lac-Q.
• Despite differences in age and success rates, the superior quality of life outcomes for endonasal DCR persisted.
• Larger, randomized studies are recommended to further validate these findings.