A modified Y-shaped mucosal flap technique in endoscopic dacryocystorhinostomy

Area of Science:

• Otolaryngology
• Ophthalmology
• Surgical Innovation

Background:

• Endoscopic dacryocystorhinostomy (DCR) is a surgical procedure to restore tear drainage.
• Conventional DCR techniques can have variable postoperative recovery outcomes.
• Optimizing flap design and support is crucial for successful DCR outcomes.

Purpose of the Study:

• To introduce and describe a novel modified Y-shaped nasal mucosal flap with tumescent sponge support for endoscopic DCR.
• To compare the postoperative recovery between the modified Y-shaped flap and the traditional D-shaped flap in endoscopic DCR.

Main Methods:

• A retrospective comparative study involving 25 patients (Group A) with the modified Y-shaped flap and 30 patients (Group B) with the conventional D-shaped flap.
• Postoperative follow-up at 1 week, 1 month, 3 months, and 12 months.
• Assessment of endoscopic scores and number of otorhinolaryngology and ophthalmology visits.

Main Results:

• Group A demonstrated significantly lower Lund-Kennedy endoscopic scores at 1 week, 1 month, and 3 months postoperatively compared to Group B.
• Patients in Group A required fewer postoperative visits to otorhinolaryngology and ophthalmology departments.
• At 12 months, Group A achieved a 100% anatomical patency rate and a 96% symptomatic cure rate, versus 90.0% and 83.3% for Group B, respectively.

Conclusions:

• The modified Y-shaped nasal mucosal flap with tumescent sponge support offers excellent anatomical patency and symptomatic cure rates in endoscopic DCR.
• This innovative technique leads to improved postoperative recovery, evidenced by lower endoscopic scores and reduced patient visits.
• The modified Y-shaped flap represents a promising advancement in endoscopic dacryocystorhinostomy surgical procedures.