For defining the site of obstruction, syringing and probing are helpful table 2. Endoscopic dacryocystorhinostomy oculoplastic eyelid. Background endonasal dacryocystorhinostomy dcr has been widely used to treat nasolacrimal duct obstruction. A comparison of external and endoscopic endonasal dacryocystorhinostomy for acquired nasolacrimal duct. Conventional dacryocystorhinostomy versus endonasal. Clinical results of endoscopic dacryocystorhinostomy using a microdebrider. Comparative study of stenting and ostium packing in endoscopic.
Endoscopic evaluation, at the surgical moment revealed that three patients had obstructive septal deformities that narrowed the nasal cavity toward the side of lacrimal duct obstruction. Stent technique for endoscopic dacryocystorhinostomy our expertise. Endoscopic dacryocystorhinostomy dcr was initially described by caldwell in the 19th century. External dcr was the gold standard method even after the endoscopic approach had been described, because of limited technology at that. The dcr ostium is defined as the postoperative opening containing the common or individual canaliculus and the surrounding lacrimal sac. Studies reporting results of external and endoscopic endonasal dacryocystorhinostomy. Endoscopic dacryocystorhinostomy article pdf available in vojnosanitetski pregled. Figure 15 ct scan, axial slice welldefined waterdensity rounded lesion. Endoscopic dacryocystorhinostomy dcr iowa head and. External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Describe the basic steps of endoscopic dacryocystorhinostomy. Endoscopic versus external approach dacryocystorhinostomy. Dacryocystorhinostomy with the increasing understanding of nasal anatomy, the advent of rigid nasal endoscopes and high definition cameras. Results of endonasal laserassisted dacryocystorhinostomy.
Dacryocystorhinostomy dcr is a surgical technique that has been increasingly used by otolaryngologists in recent years due to the im. Endoscopic dcr endoscopic dcr is a minimally invasive procedure to unblock tear ducts. Primary endoscopic dacryocystorhinostomy oregon health. Pdf on dec 10, 2018, balwant singh gendeh and others published endoscopic dacryocystorhinostomy find, read and cite all the research. The objective of present study was to compare the results of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Here, we evaluated the anatomical advantages of the uncinate process as a landmark and to study the effect of unciformectomy on success rate and complications of endonasal dcr. Dacryocystorhinostomy dcr, one of the major methods to treat dacryocystitis, is a procedure used to create a lacrimal drainage pathway into the nasal cavity. Powered endoscopic dacryocystorhinostomy springerlink. Endoscopic dcr is a minimally invasive procedure to unblock tear ducts. After 12 months, 59% 1932 of patients were asymptomatic. Dacryocystorhinostomy what does dacryocystorhinostomy.
It may be performed through an external skin incision or intranasally with or without endoscopic visualization. Shashidhar, umesh nagalotimath and deepika dixit department of otorhinolaryngology, karnataka institute of medical sciences kims, p. Dacryocystorhinostomy an overview sciencedirect topics. Endonasal endoscopic dacryocystorhinostomy one patient had mucocele of the lacrimal sac table i. Specific features of endoscopic dacryocystorhinostomy romanian. Endoscopic dacryocystorhinostomy with an otologic ttype. Pdf stent technique for endoscopic dacryocystorhinostomy. Dacryocystorhinostomy is a procedure used to bypass the nasolacrimal duct by creating an anastomosis between the lacrimal sac and the nasal mucosa beneath the middle turbinate. Endoscopic dacryocystorhinostomy dcr is a surgical intervention for epiphora caused by obstruction of the nasolacrimal duct. Reliable technique of endoscopic dacryocystorhinostomy a. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. Basic technique and keys to success learning objective upon completion, participants should be able to. Ct dcg to define the limits of the lacrimal sac and to establish the relationship. A dacryocystorhinostomy dcr creates an alternate passageway between the lacrimal sac and nasal cavity, thus bypassing the obstructed nasolacrimal duct.
Dacryocystorhinostomy medical definition merriamwebster. In the early 20th century, toti described the external dcr procedure and, with a few modifications, this procedure remains largely unchanged from. It is therefore feasible that dacryocystorhinostomy dcr may be performed via an endonasal approach. A large study that compared the use of lasers with electrocautery instruments for endoscopic dcr in 398 patients reported success rates of 92% 222242 and 90% 2831 using two different laser types, and 87% 3945 for endoscopic dacryocystorhinostomy ipg1. Pdf the endonasal surgical approach of the lacrymal sac assisted by videoendoscopy is carried out today with high success rates. Dcr can be performed either by an external approach that utilizes a cutaneous incision, or through an endoscopic approach, which includes an incision in the nasal cavity. Eighty percent of the lacrimal pathways belong anatomically to the nose. Longterm results and evolution of surgical technique. Endoscopic dacryocystorhinostomy dcr surgical technique vula. We defined functional success as complete resolution of epiphora and did not include patients with. Dacryocystorhinostomy endoscopic endonasal is a good alternative on the treatment of nasolacrimal duct obstruction. To circumvent the disadvantages of endoscopic dacryocystorhinostomy such as small rhinostomy size, high failure rate and expensive equipment, we hereby introduce a modified technique of non endoscopic mechanical endonasal dacryocystorhinostomy.
The operative approach could be external or an endoscopic approach. With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. Forty consecutive patients having complaints of watering with complete naso lacrimal duct obstruction were selected for the study. A comparison of external and endoscopic endonasal dacryocystorhinostomy for acquired nasolacrimal duct obstruction. Our experience in endoscopic dacryocystorhinostomy in 203. At each followup appointment, a nasal endoscopic examination was performed to assess the wound healing and to remove crusts and granulations if any. Endoscopic dacryocystorhinostomy as treatment for lower lacrimal.
Pdf the endonasal surgical approach of the lacrymal sac assisted by video endoscopy is carried out today with high success rates. The primary and final outcomes of endoscopic and external. Endoscopic dacryocystorhinostomy with and without silicone. Obstruction of the nld usually present with epiphora, it may also present with a mucocoele, pyocoele or recurrent acute dacryocystitis. Endoscopic dacryocystorhinostomy with and without silicone stenting. The aim of the study was to evaluate the endoscopic dacryocystorhinostomy dcr. Nonendoscopic mechanical endonasal dacryocystorhinostomy. Endoscopic dacryocystorhinostomy in functional lacrimal obstruction. Although the external and endoscopic approaches are both equally effective in relieving symptoms, endoscopic dacryocystorhinostomy has many advantages over the more conventional external approach. Reliable technique of endoscopic dacryocystorhinostomy 180 ml of boiled water.
Endoscopic dacryocystorhinostomy edcr is a currently wellestablished surgical treatment. Looking for online definition of dacryocystorhinostomy or what dacryocystorhinostomy stands for. Endoscopic endonasal dacryocystorhinostomy dcr is the best, scar free no scar, lacrimal surgery performed for restoration of tears flow into the nose from the lacrimal sac, when the nasolacrimal duct tear duct has become blocked blocked tear duct tear duct obstruction abnormal tearing or epiphora watery eyes takes place due to obstruction in the drainage system of. The major outcomes used to define surgical success included subjective. Success was defined when there were both a resolution of the symptoms of the patient, as well as patent dcr opening during the endoscopic. Endoscopic revision of external dacryocystorhinostomy. Dacryocystorhinostomy is the surgical treatment for nasolacrimal blockage. Endoscopic dacryocystorhinostomy prospective research. Surgical outcomes of external dacryocystorhinostomy and.
Two approaches of dcr have been established, endoscopic and external dcr ex. In recent years, the endoscopic approach has become more popular due to the development of nasal endoscopes and the ease. The operation is very similar to external dcr, except there is no cut through the skin and no scar afterwards. Dacrocystogram dcg was performed in 5 patients and all had evidence of blocked nasolacrimal duct figure 1. Dacryocystorhinostomy or dcr is among the common oculoplastics surgeries performed for managing epiphora due to nasolacrimal duct obstruction. Dacryocystorhinostomy, endonasal, endoscopy, epiphora, lower lacrimal. Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Introduction obstruction of the nasolacrimal duct is a common problem that can be corrected with dacryocystorhinostomy dcr. External dacryocystorhinostomy versus endoscopic endonasal. Understanding endonasal anatomy, wide endoscopic marsupialisation of the lacrimal sac, and meticulous care of the nasal mucosa are important to achieve good. The medial wall of the sac is incised or excised, facilitating drainage of tears into the nasal cavity. A dacrocystogram showing distal obstruction of right nasolacrimal. Surgical outcomes of endoscopic dacryocystorhinostomy.