Endoscopic endonasal dacryocystorhinostomy learning curve.

Area of Science:

• Ophthalmology
• Otorhinolaryngology
• Surgical Education

Background:

• Primary acquired nasolacrimal duct obstruction (PANDO) affects quality of life.
• Endoscopic endonasal dacryocystorhinostomy (EEDCR) is a standard treatment for PANDO.
• Comparing learning curves of different surgical specialties in EEDCR is crucial for optimizing training and patient outcomes.

Purpose of the Study:

• To compare the learning curves of ophthalmologists and otorhinolaryngologists performing endoscopic endonasal dacryocystorhinostomy (EEDCR) without prior experience.
• To evaluate surgical success rates and identify complications associated with EEDCR performed by these two groups.

Main Methods:

• Retrospective analysis of 90 patients undergoing EEDCR with mucosa preservation.
• Patients were divided into two groups: ophthalmologist (Group 1) and otorhinolaryngologist (Group 2).
• Data collected included surgery duration, complications, and functional success rates over a minimum 6-month follow-up.

Main Results:

• Otorhinolaryngologists had a significantly shorter mean surgical duration (36.27 min) compared to ophthalmologists (43.62 min).
• Functional success rates were high and comparable between groups (84.4% for ophthalmologists, 88.9% for otorhinolaryngologists).
• Septum intervention and intraoperative bleeding were associated with decreased functional success in both groups.

Conclusions:

• Endoscopic endonasal dacryocystorhinostomy (EEDCR) can achieve high success rates with low complications, even for ophthalmologists new to the endoscopic approach.
• Adequate training allows ophthalmologists to achieve comparable functional outcomes to experienced otorhinolaryngologists after approximately 30 cases.
• The study highlights the feasibility of EEDCR for ophthalmologists, emphasizing the importance of specialized training.