Dacryocystorhinostomy (DCR) is a surgical procedure to drain tears from lacrimal sac into nasal cavity to treat a watering eye from a blocked nasolacrimal duct, which presents with persistent epiphora. There are three approaches: external, endocanalicular/transcanalicular and transnasal. The major aim of all approaches is to re-establish tear flow from the lacrimal system into the nasal cavity. DCR was first described in 1893 by Caldwell using a nasal approach to lacrimal duct obstruction. However this method could not be widely used because of intraoperative bleeding. In 1904, Toti described the external DCR procedure. Afterwards for approximately 100 years, the gold standard treatment for nasolacrimal canal obstruction has been conventional external DCR. With the advances in endoscopic techniques and laser, endocanalicular and/or endonasal surgical procedures have become more popular. Endoscopic endonasal DCR is performed via the nasal space using a rigid Hopkins endoscope as a light source. Endoscopic transcanalicular DCR is performed via the canaliculus from the inside of lacrimal sac into the nasal space across the maxilla and lacrimal bone. In this approach osteotomy is performed either by a mechanical drill or laser energy through an optic fiber. Intranasal laser DCR was first described by Massaro et al. Since then, there have been a number of series reported using various types of laser for DCR with variable results. Laser-DCR can be performed via transcanalicular or endonasal. It is an alternative to standard external DCR procedure as it avoids the disadvantages associated with external DCR and has the advantage of making the procedure simple and fast.
KeywordsDacryocystorhinostomy Laser Transcanalicular Endonasal Simple Fast
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