The endoscope and the radiofrequency unit in DCR surgery

Endoscopic laser-assisted dacryocystorhinostomy (DCR) offers several advantages over standard external (SE) DCR. The technique eliminates the cutaneous scar and cosmetic blemish of an external dissection and causes less surgical trauma and bleeding than SE-DCR, with shortened postoperative recovery time and lessened postoperative pain. However, the equipment is expensive. We modified this technique using simple instruments such as the curette, Kerrison punch, Freer elevator, Storz endoscope, Ellman Surgitron unit, and the Javate DCR electrodes instead of the laser. Fifty patients with epiphora and nasolacrimal obstruction underwent surgery with our new technique. Fifty age-matched, paired external DCR were performed, and comparisons were made with the endoscopic procedure described. If preoperative epiphora was resolved and nasolacrimal patency was confirmed by lacrimal irrigation 3 months after tube removal, the operation was considered a success. The study attained a 90% success rate for endoscopic radiofrequency-assisted DCR, as compared to a 94% success rate (p > 0.05, not statistically significant) for the SE-DCR.