Abstract
Endonasal endoscopic dacryocystorhinostomy (EEDCR) has been popularized as a minimally invasive technique. Although preliminary reports revealed less success in comparison with external approaches, recent endonasal endoscopic surgeries on various types of DCR have preserved advantages of this technique while diminishing the failures. We described our experience on EEDCR, including the main advantages and disadvantages of it. Hundred consecutive cases of lachrymal problems underwent EEDCR utilizing simple punch removal of bone, instead of powered instrumentation or lasers. The medial aspect of the sac was removed in all of patients, while preserving normal mucosa around the sac. Hundred cases of EEDCR were performed on 81 patients, with 19 bilateral procedures. Nine procedures were performed under local anesthesia. Based on a mean 14 months follow-up, 95 cases were free of symptoms, revealing 95% success rate. The punch technique diminishes the expenses of powered or laser instrumentation with comparable results. It seems that preserving normal tissues and creating a patent rhinostomy with least surgical trauma and less subsequent scar, plays the most important role in achieving desirable results.
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References
Welham RA (1987) Management of unsuccessful lacrimal surgery. Br J Ophthalmol 71:152–157
Rosen N, Sharir M, Moverman DC, Rosner M (1989) Dacryocystorhinostomy with silicone tubes: evaluation of 233 cases. Ophthalmic Surg 20:115–119
Ibrahim HA, Batterbury M, Banhegyi G, McGalliard J (2001) Endonasal laser dacryocystorhinostomy and external dacryocystorhinostomy outcome profile in a general ophthalmic service unit: a comparative retrospective study. Ophthalmic Surg Lasers 32:220–227
Caldwell GW (1893) Two new operations for obstruction of the nasal duct with preservation of the canaliculi, and incidental description of a new lachrymal probe. NY Med J 57:581
Massaro BM, Gonnering RS, Harris GJ (1990) Endolaser laser dacryocystorhinostomy: a new approach to nasolacrimal duct obstruction. Arch Ophthalmol 108:1172–1176
Woog JJ, Metson R, Puliafito CA (1993) Holmium: YAG endonasal laser dacryocystorhinostomy. Am J Ophthalmol 116:1–10
Boush GA, Lemke BN, Dortzbach RK (1994) Results of endonasal laser-assisted dacryocystorhinostomy. Ophthalmology 101:955–959
Dolman PJ (2003) Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology 110(1):78–84
Ajalloueyan M, Fartookzadeh M, Parhizgar H (2007) Use of laser for dacrocystorhinostomy. Arch Otolaryngol Head Neck Surg 133(4):340–343
Gonnering RS, Lyon DB, Fisher JC (1991) Endoscopic laserassisted lacrimal surgery. Am J Ophthalmol 111:152–157
Ben Simon GJ, Joseph J, Lee S et al (2005) External versus endoscopic dacryocystorhinostomy for acquiered nasolacrimal duct obstruction in a tertiary referral center. Ophthalmology 112:1463–1468
Tsirbas A, Davis G, Wormald PJ (2005) Revision dacryocystorhinostomy: a comparison of endoscopic and external techniques. Am J Rhinol 19:322–325
Metson R, Woog JJ, Puliafito CA (1994) Endoscopic laser dacryocystorhinostomy. Laryngoscope 104:269–274
Gurler B, San I (2004) Long-term follow-up outcomes of nonlaser intranasal endoscopic dacryocystorhinostomy: how suitable and useful are conventional surgical instruments? Eur J Ophthalmol 14:453–460
Naraghi M, Kashfi A et al (2002) Endonasal endoscopic laser-assisted dacryocystorhinostomy. Acta Media Iranica 40(3):140–145
Nayak DR, Hazarika P et al (2005) Endoscopic dacryocystorhinostomy vs KTP 532 laser endoscopic dacryocystorhinostomy. Ind J Otolaryngol Head Neck Surg 57:278–282
Toti A (1904) Nuovo metodo conservatore di cura radicale delle suppurazioni croniche del sacco lacrimale (dacriostorinostomia). Clin Mod Pisa 10:385–387
Watkins LM, Janfaza P, Rubin PA (2003) The evolution of endonasal dacryocystorhinostomy. Surv Ophthalmol 48(1):73–84
Anijeet D, Dolan L, Macewen CJ (2011) Endonasal versus external dacryocystorhinostomy for nasolacrimal duct obstruction. Cocrhrane Database Syst Rev 19(1):CD007097
Eichhorn K, Harrison AR (2010) External vs. endonasal dacryocystorhinostomy: six of one, a half dozen of the other? Curr Opin Ophthalmol 21(5):396–403
Rahman SH, Tarafder KH, Ahmed MS, Saha KL, Tariq A (2011) Endoscopic dacryocystorhinostomy. Mymensingh Med J 20(1):28–32
Malhotra R, Wright M, Olver JM (2003) A consideration of the time taken to do dacryo-cystorhinostomy (DCR) surgery. Eye 17:691–696
Yasar C, Cem E, Hamdi ER (2000) Comparative external versus endoscopic dacryocystorhinostomy: results of 115 patients (130 eyes). Otolaryngol Head Neck Surg 123:488–491
Sprekelsen MB, Barberan MT (1996) Endoscopic dacryocystorhinostomy: Surgical technique and results. Laryngoscope 106:187–189
Mortimore S, Banhegyi GY et al (1999) Endoscopic dacryocystorhinostomy without silicon stenting. J R Coll Surg Edinb 44:371–373
Rudolf H, Marco C, Marc J (1999) External dacryocystorhinostomy versus endonasal laser dacryocystorhinostomy: a letter to editor. Ophthalmology 106:647–648
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Naraghi, M., Tabatabaii Mohammadi, S.Z., Sontou, A.F. et al. Endonasal endoscopic dacryocystorhinostomy: how to achieve optimal results with simple punch technique. Eur Arch Otorhinolaryngol 269, 1445–1449 (2012). https://doi.org/10.1007/s00405-011-1825-2
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DOI: https://doi.org/10.1007/s00405-011-1825-2