Dacryocystorhinostomy via an endoscopic approach is now widely favored and considered to result in comparable outcomes to similar surgery via an external approach. Such surgery is usually done jointly between ophthalmologists and otolaryngologists. If endoscopic surgery is to be considered, patients should have a complete preoperative assessment to facilitate surgical planning. Clearly, patients with lacrimal obstruction require a comprehensive ophthalmologic assessment to confirm the diagnosis. However, in addition nasal examination should be considered obligatory in such patients, for evaluation of any concurrent intranasal pathology or anatomical variations, and therefore ophthalmologists practicing lacrimal surgery should familiarize themselves with the use of the nasal endoscopes. Examination with a nasal speculum and headlight provides only a limited view of the anterior nasal passages, and therefore rigid nasal endoscopy should be performed as part of the standard preoperative assessment.
McNeill EJ, Kubba H, Bearn MA, et al. The management of rhinitis in patients with functional epiphora: a randomized controlled crossover trial. Am J Rhinol. 2005;19(6):588–90.PubMedGoogle Scholar
Ergin NT, Akman A, Aktas A, et al. Evaluation of nasolacrimal duct function in chronic paranasal sinus infection with Tc99 dacroscintigraphy. Laryngorhinootologie. 1999;78(7):382–6.PubMedCrossRefGoogle Scholar
Annamalai S, Kumar NA, Madkour MB, et al. An association between acquired epiphora and the signs and symptoms of chronic rhinosinusitis: a prospective case-controlled study. Am J Rhinol. 2003;17(2):111–4.PubMedGoogle Scholar