Is Stenting Really Necessary in Primary Endonasal DCR-Our Experience

Area of Science:

• Otolaryngology
• Ophthalmology
• Surgical Innovation

Background:

• Endoscopic Dacryocystorhinostomy (DCR) is a common procedure for nasolacrimal duct obstruction.
• The role and necessity of silicone intubation in endoscopic DCR remain debated.
• Optimizing surgical outcomes and minimizing complications are key goals in DCR surgery.

Purpose of the Study:

• To evaluate the relevance and efficacy of silicone intubation in endoscopic DCR.
• To compare the success rates of endoscopic DCR with and without silicone stents.
• To identify specific indications for silicone stent use in endoscopic DCR.

Main Methods:

• A prospective randomized controlled trial was conducted with 100 patients diagnosed with acquired nasolacrimal duct obstruction.
• Patients were randomized into two groups: endoscopic DCR with silicone stent (n=50) and without stent (n=50).
• Outcomes were assessed based on detailed history, examination, and overall success rates.

Main Results:

• The overall success rate for endoscopic DCR with silicone stent was 92%, and without stent was 88%.
• No statistically significant difference (p > 0.05) was observed between the two groups.
• Silicone stents were deemed not essential for routine endoscopic DCR based on these findings.

Conclusions:

• Silicone intubation is not routinely necessary for endoscopic DCR.
• Short-term stenting (up to 7 days) may be beneficial to prevent restenosis and mucosal flap coverage of the stoma.
• Stent use should be reserved for specific complex cases, including post-traumatic, revision, fibrosed sacs, and suspected canalicular blocks.