Long term study of Endoscopic versus external approach dacryocystorhinostomy in Garhwal Region

Dr Achyut N Pandey; Dr R S Bisht

Volume : IX, Issue : VI, June - 2020

Long term study of Endoscopic versus external approach dacryocystorhinostomy in Garhwal Region

Dr Achyut N Pandey, Dr R S Bisht

Abstract :

Aim To compare between powered (drill) and non–powered (kerrison punch) DCR to clarify the superiority of one over the other. Methods: Records of patients with acute dacryocystitis and operated during two years were reviewed in a teaching hospital with 50 cases of endoscopic and 30 cases of external DCR with a follow–up of minimum 6 months.Demographic characteristics, surgery types, success rate, and follow–up periods were recorded. Success was defined as the elimination of epiphora, absence of dacryocystitis, and negative syringing test result (i.e., unrestricted flow of irrigated saline to the nose). Results: 72 patients were included in the study with six having bilateral involvement, out of which 20 were male and 52 were female. The mean age for endoscopic and external DCR was 33.6 years and 46.0 years, respectively. Right eye (63.8%) was involved more commonly than left eye (36.2%). Bleeding was the most common immediate postoperative complication seen in 33.3% and 10.0% of external and endoscopic DCR cases, respectively. Primary surgical success rate was 90% and 96.7% for endoscopic and external DCR, respectively (P = 0.046). Among the endoscopic DCR group, four patients underwent revision surgery giving a total successful surgical outcome of 98% at third month of follow–up. However, at 6 month of follow–up, success rate was 92% for endoscopic DCR and 93.3% for external DCR. The difference was not statistically significant (P = 0.609). Conclusion:Intranasal endoscopic DCR is a simple, minimally invasive, day care procedure and had comparable result with conventional external DCR.