Clinical Study of Endoscopic Endonasal Dacryocystorhinostomy for Chronic DacryocystitisOur Experience in 50 Cases and Review of Literature

DR.R.BHANU MURTHY; DR.K.KISHORE; DR.S. NAGARAJU

Volume : V, Issue : VI, June - 2016

Clinical Study of Endoscopic Endonasal Dacryocystorhinostomy for Chronic DacryocystitisOur Experience in 50 Cases and Review of Literature

Dr. R. Bhanu Murthy, Dr. K. Kishore, Dr. S. Nagaraju

Abstract :

 Introduction: Chronic dacryocystitis is defined as the chronic inflammation of the lachrymal sac due to stricture of the nasolacrimal duct secondary to chronic inflammation, usually due to nasal origin. For over a century, the gold standard treatment for epiphora is Dacryocystorhinostomy. Toti’s technique of External Dacryocystorhinostomy (DCR) has been the treatment of choice for epiphora due to nasolacrimal duct obstruction since 1904 until the introduction of rigid nasal endoscopes and advent of intranasal endoscopic Dacryocystorhinostomy. Materials and Methods: A clinical study conducted in 50 cases of chronic dacryocystitis due to chronic nasolacrimal duct obstruction, who underwent Endoscopic Endonasal Dacryocystorhinostomy (lacrimal sac) surgery. The clinical study was conducted in patients with epiphora who presented to the Department of Otorhinolaryngology and Head and Neck Surgery and Department of Ophthalmology, Kurnool Medical College and Government General Hospital, Kurnool from a period of Jan 2014 to Dec 2015. Standard procedures of Endonasal Endoscopic DCR were performed and the results were compared with External Dacrocysto Rhinostomy and other procedures on lacrimal sac surgery. In our study the maximum incidence was found in third decade (36 %) of age group and the mean age was 38 years. The incidence in females (80%) were more than males (20%), left side lacrimal sac lesions (64%) are more than right sided (36%) pathology. Conclusion: Endoscopic Endonasal DCR is considered to be a cosmetic surgery for both sexes as it avoids facial scar and risk of keloid formation as in External DCR and the associated nasal pathology like DNS, Sinusitis can be corrected at same time of surgery of Endoscopic Endo Nasal DCR. Endo DCR is a day care procedure with success rate of 90%. And it’s an approach for revision cases of Endo or failed External DCR without any complications, like serious bleeding and recurrence. Endo DCR can be done in acute cases with lacrimal sac abscess or in cases with acute inflammation in patients with chronic dacryocystitis and in children with congenital NLD obstruction