Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction: creating a window with a drill without use of mucosal flaps

Abstract

Conclusion. Success and complication rates of endoscopic dacrycystorhinostomy (DCR) creating a window with a drill and without using mucosal flaps are similar to those of external DCR. Moreover, any intranasal or paranasal disease can be treated simultaneously and a superior cosmetic result is achieved. Objectives. To present success and complication rates of a case series of patients treated with the same technique of endoscopic DCR for acquired nasolacrimal duct obstruction (NLDO). Patients and methods. This was a retrospective case review of 46 patients (25 female, 21 male; mean age 57 years). All patients had acquired NLDO with epiphora. Additionally, chronic dacryocystitis was evident at presentation in five patients. The cause of NLDO was primary acquired NLDO in 35 patients and lacrimal sac mucocele in 11 patients. An endonasal endoscopic approach using a drill was performed. Temporary silicone stenting of the nasolacrimal duct system was applied. In 19 patients additional surgery (11 FESS, 3 septoplasties, 5 FESS and septoplasty) was necessary. Patient follow-up ranged between 3 and 27 months. Results. A successful functional result was obtained in 97.8% of patients. No major complications were observed. Minor complications (acute dacryocystitis or periorbital ecchymosis) occurred in four patients and were treated with antibiotics or resolved spontaneously.