Skip to main content
SpringerLink
Log in

Primary Endonasal DCR Without Stent: Our Experience and Case Series Analysis

  • Original Article
  • Published:
Indian Journal of Otolaryngology and Head & Neck Surgery Aims and scope Submit manuscript

Abstract

Endonasal dacryocystorhinostomy is widely accepted and effective treatment option for nasolacrimal duct obstruction. It can be done with or without the use of stents. This study was carried out to evaluate the results of endonasal DCR surgery and to access efficacy of this procedure without stenting. This is a prospective clinical study conducted in Departments of ENT and Ophthalmology, L.N. Medical College and J.K. Hospital, Bhopal from October 2008 to April 2012. A total of 90 patients with epiphora as evidenced by nasolacrimal duct blockage on syringing were included in the study. These patients underwent endoscopic DCR without stenting. The cases were followed up to 18 months postoperative. Surgical success was defined as anatomical patency and symptomatic relief at the end of the follow up period. Failure was defined as no symptomatic relief, and/or acute dacryocystitis, and/or non patent lacrimal drainage system. Surgical success was observed in 80 of 90 (88.89 %) patients. Incidence of complication was low as only 6 patients had minor complication of bleeding, synechie and granulation tissue formation. It was concluded that high success rates could be achieved in case of nasolacrimal duct obstruction by endoscopic DCR. Thus, we can minimize complications, discomfort, the cost of stenting and follow up visits after endonasal DCR surgery.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

Abbreviations

DCR:

Dacrocystorhinostomy,

NLD:

Nasolacrimal duct

NLDO:

Nasolacrimal duct obstruction

References

  1. Roper-Hall MJ (ed) (1989) Stallard’s eye surgery, 7th edn. Butterworth, London, p 138

    Google Scholar 

  2. Mosher HP (1921) Toti operation on lacrimal sac. Laryngoscope 31:284

    Article  Google Scholar 

  3. Caldwell GW (1983) Two new operations for obstruction of the nasal duct, with preservation of canaliculi, and an incidental description of a new lacrymal probe. N Y Med J 57:581

    Google Scholar 

  4. Stammberger H (1986) Endoscopic endonasal surgery: concepts in treatment of recurring rhinosinusitis. Part 11. Surgical technique. Otolaryngol Head Neck Surg 94(2):147–156

    Article  CAS  PubMed  Google Scholar 

  5. Kennedy DW (1985) Functional endoscopic sinus surgery technique. Arch Otolaryngol Head Neck Surg 111(10):643–649

    Article  CAS  Google Scholar 

  6. McDonogh M, Meiring JH (1989) Endoscopic trans nasal dacryocystorhinostomy. J Laryngol Otol 103(6):585–587

    Article  CAS  PubMed  Google Scholar 

  7. Yigit O, Samancioglu M, Taskin U et al (2007) External and endoscopic dacryocystorhinostomy in chronic dacryocystitis: comparison of results. Eur Archi Otorhinolaryngol 264:879–885

    Article  Google Scholar 

  8. Feretis M, Newton JR et al (2009) Comparison of external and endonasal dacryocystorhinostomy. J Laryngol Otol 123:315–319

    Article  CAS  PubMed  Google Scholar 

  9. Griffiths JD (1991) Nasal catheter use in dacryocystorhinostomy. Ophthalmic Plast Reconstr Surg 7(3):177–186

    Article  CAS  Google Scholar 

  10. Allen K, Berlin AJ (1989) Dacryocystorhinostomy failure: association with nasolacrimal silicone intubation. Ophthalmic Surg 20(7):486–489

    CAS  PubMed  Google Scholar 

  11. Naraghi M, Tabatabaii Mohammadi SZ et al (2012) Endonasal endoscopic dacryocystorhinostomy: how to achieve optimal results with simple punch technique. Eur Arch Otorhinolaryngol 269:1445–1449

    Article  PubMed  Google Scholar 

  12. Saeed BM (2012) Endoscopic DCR without stents: clinical guidelines and procedure. Eur Arch Otorhinolaryngol 269:545–549

    Article  PubMed  Google Scholar 

  13. Smirnov G, Tuomilehto H et al (2006) Silicone tubing after endoscopic dacryocystorhinostomy: is it necessary? Am J Rhinol 20(6):600–602

    Article  PubMed  Google Scholar 

  14. Smirnov G, Tuomilehto H et al (2008) Silicon tubing is not necessary after primary endoscopic dacryocystorhinostomy: a prospective randomized study. Am J Rhinol 22:214–217

    Article  PubMed  Google Scholar 

  15. Unlu HH, Gunhan K et al (2009) Long term results in endoscopic dacryocystorhinostomy: is intubation really required ? Otolaryngol Head Neck Surg 140:589–595

    Article  PubMed  Google Scholar 

  16. Gupta Nishi (2011) Improving results in endoscopic DCR. Indian J Otolaryngol Head Neck Surg 63(1):40–44

    Article  PubMed  PubMed Central  Google Scholar 

  17. Eshraghy B, Raygan F, Tabatabaie SZ et al (2012) Effect of mitomycin C on success rate in dacryocystorhinostomy with silicone tube intubation and improper flaps. Eur J Ophthalmol 22:326–329

    Article  PubMed  Google Scholar 

  18. Tsirbas A, Wormald PJ (2003) Mechanical endonasal dacryocystorhinostomy with mucosal flap. Br J Ophthalmol 87:43–47

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  19. Ramakrishnan VR, Hink EM, Durairaj VD et al (2007) Outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation. Am J Rhinol 21:753–757

    Article  PubMed  Google Scholar 

  20. Jin HR, Yeon JY, Choi MY (2006) Endoscopic dacryocystorhinostomy: creation of a large marsupialized lacrimal sac. J Korean Med Sci 21:719–723

    Article  PubMed  PubMed Central  Google Scholar 

  21. Rose GE (2004) The Lacrimal paradox: towards a greater understanding of success in lacrimal surgery. Ophthal Plast Reconstr Surg 20:262–265

    Article  PubMed  Google Scholar 

  22. Guthoff RF, Katowitz JA (2005) Essentials in ophthalmology: Oculoplastics and orbit, the apparent paradox of “success” in lacrimal drainage surgery, 3rd edn. Springer, Berlin

    Google Scholar 

  23. Martimore S, Banhegyi GY et al (1999) Endoscopic dacryocystorhinostomy without silicone stenting. J R Coll Surg Edinb 44(6):371–373

    Google Scholar 

  24. Kakkar V, Chugh J, Sachdeva S (2009) Endoscopic dacryocystorhinostomy with and without stent: a comparative study. Int J Otorhinolaryngol 9:1

    Google Scholar 

  25. Pittore B, Tan N et al (2010) Endoscopic transnasal dacryocystorhinostomy without stenting: results in 64 consecutive procedures. Acta Otorhinolaryngol Ital 30:294–298

    CAS  PubMed  PubMed Central  Google Scholar 

  26. Al-Qahtani AS et al (2012) Primary endoscopic dacryocystorhinostomy with or without silicone tubing: a prospective randomized study. Am J Rhinol Allergy 26:332–334

    Article  PubMed  Google Scholar 

  27. Naik SM, Mushannavar AS et al (2012) Endonasal dacrocystorhinostomy done with and without silicon stents—a comparative case series analysis study. Int J Head Neck Surg 3(3):147–153

    Article  Google Scholar 

  28. Shah H, Sharma S et al (2013) Comparison of surgical outcome in endoscopic dacrocystorhinostomy with and without silicon stent placement. Nat J Med Res 3(1):34–37

    CAS  Google Scholar 

Download references

Acknowledgments

The authors are grateful to Dr. Swarna Biseria Gupta, Head of Department of Ophthalmology and Dean, LN Medical College and JK Hospital for kind permission to use hospital data and guidance during the study.

Conflict of interest

None

Ethical standard

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Funding

None

Informed consent

Informed consent was obtained from all individual participants included in the study.

Author information

Authors and Affiliations

  1. Department of ENT, LN Medical College and JK Hospital, Bhopal, MP, India

    Shiv Kumar Raghuwanshi & Gaurav Batni

  2. Department of Ophthalmology, All India Institue of Medical Sciences, Bhopal, MP, India

    Sapna Raghuwanshi

  3. Emirates International Hospital, P.O. Box 18088, Al Ain, Abu Dhabi, UAE

    Mohit Agarwal

Authors
  1. Shiv Kumar Raghuwanshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Sapna Raghuwanshi
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Mohit Agarwal
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Gaurav Batni
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Shiv Kumar Raghuwanshi.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Raghuwanshi, S.K., Raghuwanshi, S., Agarwal, M. et al. Primary Endonasal DCR Without Stent: Our Experience and Case Series Analysis. Indian J Otolaryngol Head Neck Surg 67, 271–274 (2015). https://doi.org/10.1007/s12070-015-0867-y

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12070-015-0867-y

Keywords

Search

Navigation