A modified Y-shaped mucosal flap technique in endoscopic dacryocystorhinostomy

The aim of this study was to describe a new modified Y-shaped nasal mucosal flap combined with tumescent sponge support for endoscopic dacryocystorhinostomy and compare the postoperative recovery of patients who underwent the modified flap procedure with that of patients who underwent the conventional mucosal flap procedure.

This retrospective comparative study included 25 patients who underwent the new modified technique (Y-shaped nasal mucosal flap combined with tumescent sponge support, Group A) and 30 patients who underwent the traditional surgical approach (D-shaped flap procedure, Group B). Follow-up examinations were performed at 1 week, 1 month, 3 months and 12 months after surgery. Endoscopic scores in the surgical area and the number of otorhinolaryngology and ophthalmology visits were recorded.

The modified Lund-Kennedy endoscopic score of Group A was significantly lower than that of Group B at 1 week (mean: 1.640 vs. 2.933, p < 0.0001), 1 month (mean:0.720 vs. 2.233, p < 0.0001) and 3 months (median:0 vs. 1, p < 0.0001) postoperatively. Patients in Group A required fewer postoperative otorhinolaryngology (median:0 vs. 0.5, p = 0.0167) and ophthalmology (median:1 vs. 2, p = 0.0017) visits than those in Group B did. At the twelve-month follow-up, the anatomical patency rate was 100% in Group A and 90.0% in Group B, and the symptomatic cure rate was 96% in Group A and 83.3% in Group B.

The modified Y-shaped nasal mucosal flap combined with tumescent sponge support is associated with satisfactory anatomical patency and symptomatic cure rates, lower postoperative endoscopic scores, and fewer postoperative visits.