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      Results of nonendoscopic endonasal dacryocystorhinostomy

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          Abstract

          Background

          Surgical scarring on the face and disrupted anatomy in the medial canthal area following external dacryocystorhinostomy (DCR) can be avoided by an endonasal approach. This study examined the outcome of direct visualization endonasal DCR, performed by young surgeons and residents.

          Methods

          A retrospective case series of 75 consecutive endonasal DCRs performed under direct visualization from July 2002 to July 2004 were reviewed. Surgery was performed by surgeons and residents who had received no special training in the procedure. Full success was defined as no symptoms of tearing after surgery and anatomical patency with fluorescein flow on nasal endoscopy or patency to lacrimal syringing. Partial success was defined as a tearing decrease compared with prior to surgery and with anatomical patency, and failure was defined as no significant improvement in persistent tearing. The average follow-up duration was 26.83 ± 16.26 (range 6–55) months.

          Results

          Seventy-five DCRs were performed on 63 patients (four male, 59 female) of mean age 49.44 ± 16.63 (range 21–85) years. The surgery was successful in 54/75 eyes (72%), 37/54 eyes (68.5%), and 30/42 eyes (71.4%) at 6, 12, and 24 months, respectively. Partial success was achieved in 13/75 (17.3%), 9/54 (16.7%), and 9/42 (21.4%), and the failure rates were 10.7%, 14.8%, and 7.1% at 6, 12, and 24 months, respectively. The overall functional success with this technique was 74.7% and the overall anatomical patency was 92.0%. There were no serious complications arising from the surgery; three minor complications were documented, ie, an incorrectly placed silicone tube in the lower canaliculus, tube prolapse, and postoperative bleeding which needed nasal packing and eventually a developed retention cyst in the nasal cavity.

          Conclusion

          Endonasal DCR under direct visualization is a simple technique with minimal complications and a low learning curve, without the necessity for expensive instruments.

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          Author and article information

          Journal
          Clin Ophthalmol
          Clin Ophthalmol
          Clinical Ophthalmology
          Clinical Ophthalmology (Auckland, N.Z.)
          Dove Medical Press
          1177-5467
          1177-5483
          2012
          2012
          13 August 2012
          : 6
          : 1297-1301
          Affiliations
          Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand
          Author notes
          Correspondence: Passorn Preechawai, Department of Ophthalmology, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, 90110 Thailand, Tel +66 744 51380, Fax +66 744 29619, Email ppassorn@ 123456yahoo.com
          Article
          opth-6-1297
          10.2147/OPTH.S33030
          3422139
          22927743
          40c53fc1-6005-405d-9ddb-11648f9fd534
          © 2012 Preechawai, publisher and licensee Dove Medical Press Ltd

          This is an Open Access article which permits unrestricted noncommercial use, provided the original work is properly cited.

          History
          Categories
          Original Research

          Ophthalmology & Optometry
          endonasal dcr,lacrimal surgery,nasolacrimal duct obstruction,dacryocystorhinostomy

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