[External vs. endonasal dacryocystorhinostomy: Comparison of patient-reported functional impact and quality of life]

The goal of this study is to compare the functional outcomes and impact on quality of life of external and endonasal dacryocystorhinostomies using the Lac-Q questionnaire.

This was an observational, retrospective, and comparative study conducted at Caen University Hospital between January 2019 and December 2022. Patients who underwent external or endonasal DCR were evaluated using the French translation of the Lac-Q questionnaire, completed between February 2024 and February 2025. Collected data included pre- and postoperative scores for functional and social impact, overall satisfaction, and cosmetic discomfort.

Thirty-nine patients were included (29 external, 10 endonasal). Postoperatively, a significant improvement in total score, functional score, and social impact score was observed in both groups (P<0.001). Satisfaction rates were high, and cosmetic concerns were minimal. No statistically significant difference was found between the techniques in terms of score improvement (P=0.175).

Both external and endonasal DCR significantly improve symptoms and quality of life, with no difference between techniques. Assessment using the Lac-Q allows quantification of this functional and social benefit, complementing traditional anatomical criteria. As both approaches yield comparable results, the choice of technique should be guided by the clinical context and the preferences of both surgeon and patient.