A Comparative Study of External and Endonasal DCR in Primary Acquired Nasolacrimal Duct Obstruction

Yogeswari A; Rita Hepsi Rani M; Heber Anandan; Rohini A

Volume : V, Issue : II, February - 2016

A Comparative Study of External and Endonasal DCR in Primary Acquired Nasolacrimal Duct Obstruction

Yogeswari A, Rita Hepsi Rani M, Heber Anandan, Rohini A

Abstract :

<p>&nbsp;Aim &ndash; To study and compare the outcomes and adverse events in external and endonasal DCR Materials and Methods &ndash; Prospective, open label, interventional clinical study with 50 patients. Out of the 50 patients,25 patients underwent endoscopic DCR and 25 external DCR. during June 2013&ndash;May 2014 in a tertiary care centre diagnosed to have acquired primary nasolacrimal duct obstruction in chronic state were included. Acute cases of dacryocystitis, revision DCR, nasal and sinus pathology, trauma were excluded. Data regarding Lacrimal drainage system syringing, incidence of haemorrhage, infection &amp; wound dehiscence was assessed. Standard external and endonasal DCR procedures were performed by a single surgeon in the same setting. Postoperative follow up was at 1 week, 1 month, 3 months, 6 months and 1 year. Results &ndash; Female preponderance was seen in both groups. Massive intraoperative bleeding was noted in 4% patients in endonasal DCR, and 8% in external DCR. Post opertaive hemorrhage was seen in 12% of patients in endonasal DCR &amp; 4% of patients in external DCR. Success rate was more in external DCR but not statistically significant. In external DCR, cosmetic satisfaction was seen in 84% of patients with 96 % having good symptom relief where as in endonasal DCR it was 100% and 88% respectively Conclusion&ndash; The success rate of external DCR was higher than endonasal DCR. Endoscopic DCR is an attractive alternative in preserving lacrimal pump system and leaving no cutaneous scar.</p>