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Updated: Aug 24, 2026
Transcanalicular Diode Laser-assisted Dacryocystorhinostomy for the Treatment of Primary Acquired Nasolacrimal Duct Obstruction
Published on: October 13, 2017
Osteotomy Techniques in Endoscopic Dacryocystorhinostomy: A Three-Decade Comparative Cohort Study
Karl El Mendelek1, Amjad Damaj1, Jihad El Khoury1
1Department of Otolaryngology-Head and Neck Surgery Saint George Hospital University Medical Center Beirut Lebanon.
Objective:
Endoscopic dacryocystorhinostomy (DCR) is a well-established surgical procedure used to restore lacrimal drainage in patients with nasolacrimal duct obstruction. Various instrumentation techniques have been used for lacrimal bone osteotomy; however, their comparative effectiveness remains debated. This study aimed to evaluate surgical outcomes of endoscopic DCR performed using four different instrumentation techniques.
Methods:
This retrospective comparative cohort study included 360 consecutive endoscopic DCR procedures performed on 312 adult patients between 1995 and 2024 in a tertiary care center. All surgeries were performed by a single surgeon. Osteotomy was performed using a drill, microdebrider, Kerrison punch, or thulium:YAG laser. Surgical success was defined as resolution of symptoms and confirmation of a patent neo-ostium on follow-up. Comparative statistical analysis was performed to evaluate differences in success rates among techniques.
Results:
The overall success rate was 95.3%. Success rates were comparable across all instrumentation techniques, with no statistically significant difference observed between groups (p = 0.99). Minor postoperative complications occurred in 2.8% of procedures.
Conclusion:
Endoscopic DCR demonstrated high success rates across all instrumentation modalities. Surgical outcome appears to depend more on surgical technique and experience than on the specific instrument used for osteotomy.
