Skip to main content
Log in

Endonasal endoscopic dacryocystorhinostomy: how to achieve optimal results with simple punch technique

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

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.

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

Access this article

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

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6

Similar content being viewed by others

References

  1. Welham RA (1987) Management of unsuccessful lacrimal surgery. Br J Ophthalmol 71:152–157

    Article  PubMed  CAS  Google Scholar 

  2. Rosen N, Sharir M, Moverman DC, Rosner M (1989) Dacryocystorhinostomy with silicone tubes: evaluation of 233 cases. Ophthalmic Surg 20:115–119

    PubMed  CAS  Google Scholar 

  3. 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

    PubMed  CAS  Google Scholar 

  4. 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

    Google Scholar 

  5. Massaro BM, Gonnering RS, Harris GJ (1990) Endolaser laser dacryocystorhinostomy: a new approach to nasolacrimal duct obstruction. Arch Ophthalmol 108:1172–1176

    Article  PubMed  CAS  Google Scholar 

  6. Woog JJ, Metson R, Puliafito CA (1993) Holmium: YAG endonasal laser dacryocystorhinostomy. Am J Ophthalmol 116:1–10

    PubMed  CAS  Google Scholar 

  7. Boush GA, Lemke BN, Dortzbach RK (1994) Results of endonasal laser-assisted dacryocystorhinostomy. Ophthalmology 101:955–959

    PubMed  CAS  Google Scholar 

  8. Dolman PJ (2003) Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology 110(1):78–84

    Article  PubMed  Google Scholar 

  9. Ajalloueyan M, Fartookzadeh M, Parhizgar H (2007) Use of laser for dacrocystorhinostomy. Arch Otolaryngol Head Neck Surg 133(4):340–343

    Article  PubMed  Google Scholar 

  10. Gonnering RS, Lyon DB, Fisher JC (1991) Endoscopic laserassisted lacrimal surgery. Am J Ophthalmol 111:152–157

    PubMed  CAS  Google Scholar 

  11. 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

    Article  PubMed  Google Scholar 

  12. Tsirbas A, Davis G, Wormald PJ (2005) Revision dacryocystorhinostomy: a comparison of endoscopic and external techniques. Am J Rhinol 19:322–325

    PubMed  Google Scholar 

  13. Metson R, Woog JJ, Puliafito CA (1994) Endoscopic laser dacryocystorhinostomy. Laryngoscope 104:269–274

    PubMed  CAS  Google Scholar 

  14. 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

    PubMed  CAS  Google Scholar 

  15. Naraghi M, Kashfi A et al (2002) Endonasal endoscopic laser-assisted dacryocystorhinostomy. Acta Media Iranica 40(3):140–145

    Google Scholar 

  16. Nayak DR, Hazarika P et al (2005) Endoscopic dacryocystorhinostomy vs KTP 532 laser endoscopic dacryocystorhinostomy. Ind J Otolaryngol Head Neck Surg 57:278–282

    Google Scholar 

  17. Toti A (1904) Nuovo metodo conservatore di cura radicale delle suppurazioni croniche del sacco lacrimale (dacriostorinostomia). Clin Mod Pisa 10:385–387

    Google Scholar 

  18. Watkins LM, Janfaza P, Rubin PA (2003) The evolution of endonasal dacryocystorhinostomy. Surv Ophthalmol 48(1):73–84

    Article  PubMed  Google Scholar 

  19. Anijeet D, Dolan L, Macewen CJ (2011) Endonasal versus external dacryocystorhinostomy for nasolacrimal duct obstruction. Cocrhrane Database Syst Rev 19(1):CD007097

    Google Scholar 

  20. 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

    Article  PubMed  Google Scholar 

  21. Rahman SH, Tarafder KH, Ahmed MS, Saha KL, Tariq A (2011) Endoscopic dacryocystorhinostomy. Mymensingh Med J 20(1):28–32

    PubMed  CAS  Google Scholar 

  22. Malhotra R, Wright M, Olver JM (2003) A consideration of the time taken to do dacryo-cystorhinostomy (DCR) surgery. Eye 17:691–696

    Article  PubMed  CAS  Google Scholar 

  23. 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

    Article  Google Scholar 

  24. Sprekelsen MB, Barberan MT (1996) Endoscopic dacryocystorhinostomy: Surgical technique and results. Laryngoscope 106:187–189

    Article  PubMed  CAS  Google Scholar 

  25. Mortimore S, Banhegyi GY et al (1999) Endoscopic dacryocystorhinostomy without silicon stenting. J R Coll Surg Edinb 44:371–373

    PubMed  CAS  Google Scholar 

  26. Rudolf H, Marco C, Marc J (1999) External dacryocystorhinostomy versus endonasal laser dacryocystorhinostomy: a letter to editor. Ophthalmology 106:647–648

    Google Scholar 

Download references

Conflict of interest

All Authors state that they don’t have any financial relationship with the organization that sponsored the research.

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Mohsen Naraghi.

Rights and permissions

Reprints and permissions

About this article

Cite this article

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

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00405-011-1825-2

Keywords

Navigation