Dacryocystorhinostomy: Evolution of endoscopic techniques after 498 cases

Area of Science:

• Otolaryngology
• Ophthalmology
• Surgical Innovation

Background:

• Endoscopic dacryocystorhinostomy (EDCR) is a recognized surgical treatment for nasolacrimal duct obstruction.
• It offers a viable alternative to traditional external surgical methods.

Purpose of the Study:

• To retrospectively analyze the outcomes of 498 EDCR procedures performed on 401 patients.
• Evaluate the efficacy of EDCR in both primary and revision cases.

Main Methods:

• Procedures included unilateral and bilateral EDCR with Catalano's silicone stent placement.
• Preoperative assessment involved fluorescein tests, probing, irrigation, nasal endoscopy, and CT scans.
• Success was defined by ostium patency (anatomical) and resolution of epiphora (functional).

Main Results:

• High anatomical success rates were observed: 91.54% for primary and 89.36% for revision EDCR.
• Functional success rates were also significant: 90.4% for primary and 85.1% for revision cases.
• Even after a second revision, anatomical and functional success rates remained high at 90.1% and 88.7%, respectively.

Conclusions:

• EDCR is a validated and effective surgical approach for primary and revision nasolacrimal duct obstruction.
• Achieving optimal anatomical and functional results hinges on meticulous surgical technique and diligent follow-up.