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Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
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Endoscopic Dacryocystorhinostomy With Modified Mucosal Flap Technique
Mustafa Vatansever1, Özer Dursun
1Department of Ophthalmology, Faculty of Medicine, Mersin University, Mersin, Turkey.
The Journal of Craniofacial Surgery
|October 5, 2022
Summary
Endoscopic dacryocystorhinostomy (E-DCR) using a modified inverted U flap significantly improves functional success rates and reduces granulation tissue compared to flapless surgery.
Area of Science:
- Ophthalmology
- Surgical Innovation
Background:
- Endoscopic dacryocystorhinostomy (E-DCR) is a common procedure for nasolacrimal duct obstruction.
- Traditional E-DCR techniques may have varying success rates and complication profiles.
Purpose of the Study:
- To evaluate the efficacy of a mucosa-sparing technique using a modified inverted U flap in E-DCR.
- To compare the functional success and complication rates between E-DCR with and without a mucosal flap.
Main Methods:
- A comparative study involving 42 patients in a flapless E-DCR group (group 1) and 41 patients in a modified inverted U mucosal flap E-DCR group (group 2).
- Patients were followed up for at least 12 months postoperatively.
- Functional success and postoperative complications, specifically granulation tissue formation, were analyzed.
Main Results:
- The modified inverted U flap group achieved a significantly higher functional success rate (95.1%) compared to the flapless group (81%) (P = 0.04).
- Postoperative granulation tissue formation was significantly lower in the flap group (4.88%) than in the flapless group (20.4%) (P = 0.02).
Conclusions:
- Mucosa-sparing E-DCR with a modified inverted U flap is a superior technique for achieving higher functional success.
- This flap technique effectively reduces the incidence of postoperative granulation tissue formation.
