Endoscopic Dacryocystorhinostomy: Advantage over External Approach

Abstract

Introduction Although external DCR was considered to be the Gold Standard treatment for NLD obstruction, endoscopic DCR appears to give comparable results,  with the advantage of the absence of external facial scar and no disruption of the medial palpebral ligament or the angular facial vessels. This study aims to evaluate the outcome of endoscopic dacryocystorhinostomy (DCR) and compare with the outcome of external DCR, based on data available on literature search. Materials and Methods In this prospective, longitudinal, interventional study, 67 cases of chronic dacryocystitis were operated endoscopically from January 2017 to December 2018. All patients were documented about detailed medical and operative history, thorough medical check up including ocular and ENT examination. Level of obstruction of nasolacrimal duct (NLD) was diagnosed by lacrimal syringing and probing. Surgery was performed under local anaesthesia except in uncooperative patients where general anaesthesia was used. 0˚ & 30˚ endoscopes were used in surgery. The surgical outcomes and complications were recorded, analyzed and compared to those of external DCR from available literature.   Results The overall success rate of endoscopic DCR was 94.7%, which is closely comparable to external DCR. Conclusion Endoscopic DCR is an effective and safe alternative to external DCR, with comparable results and better patient satisfaction.