Outcome of Endonasal Endoscopic Dacryocystorhinostomy Without Stent

Abstract

Background: Dacryocystorhinostomy is the surgical bypass of the lacrimal sac and duct for the treatment of epiphora. Endonasal endoscopic dacryocystorhinostomy has been popularized as a minimally invasive technique. Objective: the study aims to highlight the endonasal endoscopic DCR without stenting and to evaluate the results of the surgical procedure. Patients and Method: This was a prospective study of 18 patients referred from the ophthalmology department for dacryocystorhinostomy after having been diagnosed as distal obstruction of nasolacrimal duct or sac. Data were collected through full history from the patients and clinical examination. Endoscopic dacryocystorhinostomy was performed without stent between January 2019 and January 2020 in Al Imamain Al Kadhimain Medical City and Al Qimma private hospital. Results: The mean age was 34.83 years , range (12-53) years , 15 females(83.33%) and 3 males (16.67%) , 10 right eyes(55.56%) and 8 left eyes(44.44%) . All patients presented with epiphora, 17 of them (94.44%) presented with medial canthal discharge and 14 of them(77.78%) had medial canthal swelling with a mean duration of symptoms of 8.72 (5.5-14) months. Four patients were sent for a CT scan. Five patients(27.78%) had a septoplasty, two patients(11.11%) had conchoplasty to improve surgical access. The mean duration of surgery was 39.99 minutes, no intraoperative complications, one patient(5.55%) developed granuloma at the rhinostoma after 4 weeks and two patients(11.11%) developed synechia between the neo-ostium and middle turbinate after 3-6 weeks and one patient(5.55%) had a recurrence after 12 weeks. The success rate was 94.44%. Conclusions: The endoscopic endonasal DCR is a successful surgery with low serious complications for treatment of distal nasolacrimal drainage obstruction if adequate sac exposure and good marsupialization are performed.