Endonasal dacryocystorhinostomy with mucosal flaps: our experience

Abstract

The endoscopic dacryocystorhinostomy (DCR) has distinct advantage over external DCR. There is no ugly scar on the face, less intraoperative bleeding, it is a daycare procedure and patient is discharged on the same day evening. Endoscopic DCR is considered to be a superior alternative technique to the conventional external DCR. Patients diagnosed with nasolacrimal duct obstruction between Jan 2009 and Jan 2011 were included in the study. One hundred and twenty endo DCR were performed with conventional 'cold steel' instruments. The technique involved complete exposure and marsupialization of the lacrimal sac. The surgical technique involved the creation of nasal mucosal and large posterior lacrimal flaps at the medial lacrimal sac wall and the two flaps were placed in close apposition. Success was defined as complete resolution of epiphora and a patent lacrimal system, evaluated by lacrimal irrigation and endoscopy, 1 year postoperatively.

Keywords: Chronic dacryocystitis; Mucosal preservation technique; Sac syringing.

Fig. 1

Localization of block by diagnostic syringing

Fig. 2

Distribution of cases according to age

Fig. 3

Patent ostium after 1 year followup

Fig. 4

Granulation tissue blocking the ostium after 6 months followup