A Comparison of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy

Dr. Prashant Hippargekar; Dr. Rupali Gaikwad; Dr. Sudhir Bhise; Dr. Shankar Kothule

Volume : IX, Issue : VI, June - 2020

A Comparison of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy

Dr. Prashant Hippargekar, Dr. Rupali Gaikwad, Dr. Sudhir Bhise, Dr. Shankar Kothule

Abstract :

Background: Dacryocystorhinostomy (DCR) can be performed either through external or endoscopic approach. The present study was undertaken to compare the external and endonasal DCR surgical procedure in regards to duration of surgery, intra and postoperative complications and postoperative success rate. Method: Retrospective comparative study. Total 100 symptomatic cases of epiphora which were diagnosed as NLD obstruction and chronic dacryocystitis were included in the study. All 100 patients were prospectively randomized into two groups EX–DCR and EN–DCR. All patients were followed at 7th day, 1 and 6 months interval postoperatively. Results: There was no statistically significant difference between the two groups in terms of age, sex and complications. (Respectively p=0.46, p=0.57, p=o.1). However, the number of females was higher than the number of males in the two groups. Physiological failure were seen 2 cases (8%) of external DCR due to pump failure resulting from the interruption of medial canthal anatomy, orbicularis oculi muscles, but none cases were seen in endonasal DCR . The success rate was 96% in the endoscopic DCR group and 84% in the external DCR group. There was no statistically significant difference in the success rate between the two groups (p=0.609). Conclusion: In current study there was no statistical difference in term of complications and success rate between external and endonasal DCR however, physiological failure was seen in external DCR due to disruption of the physiological pump mechanism after dacryocystorhinostomy. In contrast endonasal DCR preserves lacrimal pump physiology.