Twenty years experience with intranasal transseptal dacryocystorhinostomy

The intranasal transeptal approach for treating chronic dacryocystitis has been utilized by the authors since 1959. A total of 305 operations have been performed with a high success rate and very low complication rate. The intranasal approach is preferred since it allows good visualization of the lacrimal sac, avoids a facial scar, and is most successful. Two hundred and eighty-four primary operations were performed with an 89% success. Of 29 failures, 25 were re-operated on with only 2 failures. Counting patients who required a revision operation, the overall success rate was 99%. Most revisions had to be performed because of scar formation in the nose or bony regrowth over the nasal opening. Complications were few with two patients having postoperative bleeding requiring nose to be repacked, two small septal perforations, one periorbital abscess and one case in which there was severe scar formation in the nose.