DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20213891

Endoscopic endonasal dacryocystorhinostomy-an experience in a tertiary care hospital

Atishkumar B. Gujrathi, Paritosh A. Kamble, Shashin Khadkekar, Nishikant Gadpayale, Yogesh Paikrao, Harshada Kurande, Indutai Rathod

Abstract


Background: Dacryocystorhinostomy is a surgical procedure by which the lacrimal flow is diverted into the nasal cavity by making an opening in the lacrimal sac when the nasolacrimal duct gets blocked. The operation can be carried out using either an external or endonasal surgical approach.

Methods: This is a clinical observational study done on 50 patients with chronic dacryocystitis with obstruction at the level of sac or nasolacrimal duct. This study was conducted at Dr. Shankarrao Chavan government medical college, Nanded, during the period of 2 years (2018-2020). Patients were evaluated and operated for endoscopic endonasal dacryocystorhinostomy.

Results: The mean age of studied cases was 33.92±12.13 years. The M:F ratio was 0.78. Epiphora was the predominant complaint in all cases 100%. Swelling of lacrimal sac was present in 24% cases and Pain on affected side was present in 18% cases. 6% patients had fistula on the side of block. 12% patients had mucocele and 14% patients had pyocele on the affected side. Left and right side was involved in 54% and 40% cases respectively. The disease presented bilaterally in 06% cases. 80% patients had no complications after endonasal endoscopic dacryocystorhinostomy (EEDCR) surgery. Rate of surgical success was 92%.

Conclusions: Nasolacrimal duct obstruction is more common among females and in middle aged persons. EEDCR is treatment which provides patients relief from the symptoms without any scar and also preserves nasolacrimal pump system with high success rate. It may prove better surgical technique in chronic dacryocystitis.


Keywords


Dacrocystitis, Endonasal dacrocystorhinostomy, EEDCR

Full Text:

PDF

References


Fergie N, Jones NS. Dacryocystorhinostomy. In: Michael Gleeson, George G Browning, Martin J Burton, Ray Clarke et al, editors. Scott-Brown’s Otorhinolaryngology, Head and Neck Surgery. 7th ed. vol 2. Great Britain: Hodder Arnold. 2008;1689-98.

Dalgleish R. Idiopathic acquired lacrimal drainage obstruction. Bri J Ophthalmol. 1967;51:463-8.

Wormald PJ. Powered endoscopic dacryocystorhinostomy. Laryngoscope. 2002;112:69-72.

Eloy P, Bertrand B, Martinez M, Hoebeke M, Watelet JB, Jamart J. Endonasal dacryocystorhinostomy: indications, technique and results. Rhinology. 1995;33:229-33.

Hartikainen J. Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Laryngoscope. 1998;108:1861-6.

Mukhtar SA, Jamil AZ, Ali Z. Efficacy of External Dacryocystorhinostomy (DCR) with and without Mitomycin-C in Chronic Dacryocystitis. J College Physicians Surgeons Pakistan. 2014;24(10):732-5.

Alzarei AH, Ardi TE, Alshihri KA, Algarni SN, Alameri DH, Almutari T. Endoscopic dacryocystrhinostomy: The experience of a tertiary care hospital in the kingdom of Saudi Arabia. Med J Cairo University. 2011;79(2).

Lee JJ, Lee HM, Bin LH, Seo SW, Ahn HB, Lee SB. Learning Curve for Endoscopic Endonasal Dacryocystorhinostomy. Korean J Ophthalmol. 2017;31(4):299.

Kulkarni G. Comparative study of endonasal dacryocystorhinostomy with and without adjunctive topical use of mitomycin C. J otolaryngol-ENT res. 2017;7(2):62-5.

Araujo Filho BC, Voegels VL, Butugan O, Neto CD, Lessa MM. Endoscopic dacryocystrhinostomy. Braz. J Otorhinolaryngol. 2005;71(6):721-5.

Ceylan SM, Erdoğan C, Sozen T, Kanmaz MA, Disikirik I, Jafarov S et al. The Fibrin Glue Application Enhances Surgical Success Rate in Endonasal Endoscopic Dacryocystorhinostomy eith Lacrimal Sac Preservation. Ear Nose Throat J. 2021;100(5):483S-8.

Priya M, Puttewar MP, Kumar SJ, Bakshi SS. Study of Endonasal Endoscopic Dacryo-cystorhinostomy with Special Reference to Mitomycin-C. Indian J Otolaryngol Head Neck Surg. 2019;71:1972-80.

Yarmohammadi ME, Ghasemi H, Jafari F, Izadi P, Nadoushan MJ, Chin NS. Teamwork endoscopic endonasal surgery in failed external dacryocystorhinostomy. J Ophthal Vision Res. 2016;11(3):282.

Vaghela M, Patel A, Patel V, Dhanani A. Evaluation of the results endonasal dacrocystorhinostomy in patients with DCR. Int J Otorhinolaryngol Head Neck Surg. 2017;3(2):184.