IP International Journal of Ocular Oncology and Oculoplasty


A comparative study of external dacryocystorhinostomy to recanalize the nasolacrimal duct with endonasal approach


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Author Details: Aalok Kumar, Ajay Kumar Arya, Ashish Ghosh

Volume : 3

Issue : 1

Online ISSN : 2581-5016

Print ISSN : 2581-5024

Article First Page : 33

Article End Page : 35


Abstract

Aim: To evaluate the comparison of efficacy and adverse effects between endonasal and external dacryocystorhinostomy(DCR).
Materials and Methods: Prospective, interventional, comparative study for 76 patients of symptomatic non-traumatic naso-lacrimal duct obstruction. Patients with previously failed surgery were excluded. 36 patients underwent recanalization with endonasal approach using endoscope (0, 30 and 70 degree) equipped by video endoscopy for direct visualization on monitor and 40 patients underwent external dacryocystorhinostomy. Follow up done on day 1, 7, 21, 3 months, 6 months and one year post-operatively. Evaluation was done on the basis of symptomatic relief and patency of nasolacrimal duct on lacrimal syringing. Data was analyzed by chi square test and unpaired t- test. P value <0.05 was considered statistically significant.
Results: Success defined as an asymptomatic patient or freely patent syringing at the end of one year of follow up was 82.50% (33 patients) in external DCR group and 80.56% (27 patients) in endonasal DCR group. Success was comparable in both the groups (p>0.05). Surgical time was significantly less in endonasal DCR than in external DCR (p<0.001). Rehabilitation was rapid in endonasal group and was considered statistically significant (p value<0.05). External DCR group had 5 cases having hemorrhage requiring intervention, 4 wound dehiscence and two got infected post operatively, these complications were reduced in endonasal DCR group. However the success rate in these patients was comparable to the others within the group (p>0.05).
Conclusion: External DCR surgery is regarded as the gold standard in treatment of nasolacrimal duct obstruction. Endonasal DCR surgery had success rate comparable to external DCR surgery. Surgical time was significantly less and rehabilitation was significantly fast in endonasal DCR surgery. Endonasal DCR surgery is a good option for external DCR surgery as it is cosmetically better, takes less surgical time and has fast rehabilitation.

Keyword:
Endoscope, Nasolacrimal duct obstruction, Recanalization

Doi No:-10.18231