Endonasal endoscopic dacryocystorhinostomy: Our experience

D. Deviprasad, S. G. Mahesh, K. Pujary, S. Pillai, S. A. Mallick, V. Jain

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

Objectives To study the outcome of endonasal endoscopic dacryocystorhinostomy (DCR) with or without mucosal flap preservation, without mitomycin local application, silicon tube stenting or laser assistance. To determine the duration of the surgical procedure of DCR, influence of simultaneously performed endonasal endoscopic procedures for concomitant sinonasal diseases.Methods Combined retrospective and prospective study in our tertiary referral center. 24 patients with chronic dacryocystitis underwent 25 standard endonasal endoscopic DCR procedures, 10 with and 15 without mucosal flap preservation. 6 of these had concomitant sinonasal diseases for which they underwent septoplasty or functional endoscopic sinus surgery (FESS) or both, simultaneously or as staged procedures. Relief from epiphora and patency of the nasolacrimal fistula was assessed by nasal endoscopy and syringing of the lacrimal apparatus at 1 week, 3 weeks and 3 months postoperatively.Results Out of 18 patients who underwent only DCR, 17 patients (94.44%) had complete relief from epiphora. Out of 6 patients who underwent 7 DCRs with concomitant sinonasal surgery, 5 patients (85.71%) had complete relief from epiphora. Overall 23 out of 25 DCRs (92%) had complete relief. In 15 of the 25 procedures, mucosal flap was excised completely. In remaining 10 procedures, flap was trimmed, repositioned to cover exposed bone around the newly created nasolacrimal fistula. In either situation, only one patient each had partial block of the nasolacrimal fistula. Average duration of the surgical procedure of DCR was 18 min.Conclusion Endonasal endoscopic DCR is a viable alternative to external DCR, co-existing sinonasal diseases can be managed simultaneously, as may be required in 25% of cases. It can be performed under 20 min without mucosal flap preservation, mitomycin local application, silicon tube stenting or laser assistance and can still provide a good success rate (92%) with less complications.

Original languageEnglish
Pages (from-to)223-226
Number of pages4
JournalIndian Journal of Otolaryngology and Head and Neck Surgery
Volume61
Issue number3
DOIs
Publication statusPublished - 01-06-2009

Fingerprint

Dacryocystorhinostomy
Lacrimal Apparatus Diseases
Fistula
Mitomycin
Silicon
Lasers
Dacryocystitis
Lacrimal Apparatus
Nose
Tertiary Care Centers
Endoscopy
Retrospective Studies
Outcome Assessment (Health Care)
Prospective Studies
Bone and Bones

All Science Journal Classification (ASJC) codes

  • Surgery
  • Otorhinolaryngology

Cite this

Deviprasad, D. ; Mahesh, S. G. ; Pujary, K. ; Pillai, S. ; Mallick, S. A. ; Jain, V. / Endonasal endoscopic dacryocystorhinostomy : Our experience. In: Indian Journal of Otolaryngology and Head and Neck Surgery. 2009 ; Vol. 61, No. 3. pp. 223-226.
@article{45609e078b0d426592164c0545ac9105,
title = "Endonasal endoscopic dacryocystorhinostomy: Our experience",
abstract = "Objectives To study the outcome of endonasal endoscopic dacryocystorhinostomy (DCR) with or without mucosal flap preservation, without mitomycin local application, silicon tube stenting or laser assistance. To determine the duration of the surgical procedure of DCR, influence of simultaneously performed endonasal endoscopic procedures for concomitant sinonasal diseases.Methods Combined retrospective and prospective study in our tertiary referral center. 24 patients with chronic dacryocystitis underwent 25 standard endonasal endoscopic DCR procedures, 10 with and 15 without mucosal flap preservation. 6 of these had concomitant sinonasal diseases for which they underwent septoplasty or functional endoscopic sinus surgery (FESS) or both, simultaneously or as staged procedures. Relief from epiphora and patency of the nasolacrimal fistula was assessed by nasal endoscopy and syringing of the lacrimal apparatus at 1 week, 3 weeks and 3 months postoperatively.Results Out of 18 patients who underwent only DCR, 17 patients (94.44{\%}) had complete relief from epiphora. Out of 6 patients who underwent 7 DCRs with concomitant sinonasal surgery, 5 patients (85.71{\%}) had complete relief from epiphora. Overall 23 out of 25 DCRs (92{\%}) had complete relief. In 15 of the 25 procedures, mucosal flap was excised completely. In remaining 10 procedures, flap was trimmed, repositioned to cover exposed bone around the newly created nasolacrimal fistula. In either situation, only one patient each had partial block of the nasolacrimal fistula. Average duration of the surgical procedure of DCR was 18 min.Conclusion Endonasal endoscopic DCR is a viable alternative to external DCR, co-existing sinonasal diseases can be managed simultaneously, as may be required in 25{\%} of cases. It can be performed under 20 min without mucosal flap preservation, mitomycin local application, silicon tube stenting or laser assistance and can still provide a good success rate (92{\%}) with less complications.",
author = "D. Deviprasad and Mahesh, {S. G.} and K. Pujary and S. Pillai and Mallick, {S. A.} and V. Jain",
year = "2009",
month = "6",
day = "1",
doi = "10.1007/s12070-009-0071-z",
language = "English",
volume = "61",
pages = "223--226",
journal = "Indian Journal of Otolaryngology and Head and Neck Surgery",
issn = "2231-3796",
publisher = "Springer India",
number = "3",

}

Endonasal endoscopic dacryocystorhinostomy : Our experience. / Deviprasad, D.; Mahesh, S. G.; Pujary, K.; Pillai, S.; Mallick, S. A.; Jain, V.

In: Indian Journal of Otolaryngology and Head and Neck Surgery, Vol. 61, No. 3, 01.06.2009, p. 223-226.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Endonasal endoscopic dacryocystorhinostomy

T2 - Our experience

AU - Deviprasad, D.

AU - Mahesh, S. G.

AU - Pujary, K.

AU - Pillai, S.

AU - Mallick, S. A.

AU - Jain, V.

PY - 2009/6/1

Y1 - 2009/6/1

N2 - Objectives To study the outcome of endonasal endoscopic dacryocystorhinostomy (DCR) with or without mucosal flap preservation, without mitomycin local application, silicon tube stenting or laser assistance. To determine the duration of the surgical procedure of DCR, influence of simultaneously performed endonasal endoscopic procedures for concomitant sinonasal diseases.Methods Combined retrospective and prospective study in our tertiary referral center. 24 patients with chronic dacryocystitis underwent 25 standard endonasal endoscopic DCR procedures, 10 with and 15 without mucosal flap preservation. 6 of these had concomitant sinonasal diseases for which they underwent septoplasty or functional endoscopic sinus surgery (FESS) or both, simultaneously or as staged procedures. Relief from epiphora and patency of the nasolacrimal fistula was assessed by nasal endoscopy and syringing of the lacrimal apparatus at 1 week, 3 weeks and 3 months postoperatively.Results Out of 18 patients who underwent only DCR, 17 patients (94.44%) had complete relief from epiphora. Out of 6 patients who underwent 7 DCRs with concomitant sinonasal surgery, 5 patients (85.71%) had complete relief from epiphora. Overall 23 out of 25 DCRs (92%) had complete relief. In 15 of the 25 procedures, mucosal flap was excised completely. In remaining 10 procedures, flap was trimmed, repositioned to cover exposed bone around the newly created nasolacrimal fistula. In either situation, only one patient each had partial block of the nasolacrimal fistula. Average duration of the surgical procedure of DCR was 18 min.Conclusion Endonasal endoscopic DCR is a viable alternative to external DCR, co-existing sinonasal diseases can be managed simultaneously, as may be required in 25% of cases. It can be performed under 20 min without mucosal flap preservation, mitomycin local application, silicon tube stenting or laser assistance and can still provide a good success rate (92%) with less complications.

AB - Objectives To study the outcome of endonasal endoscopic dacryocystorhinostomy (DCR) with or without mucosal flap preservation, without mitomycin local application, silicon tube stenting or laser assistance. To determine the duration of the surgical procedure of DCR, influence of simultaneously performed endonasal endoscopic procedures for concomitant sinonasal diseases.Methods Combined retrospective and prospective study in our tertiary referral center. 24 patients with chronic dacryocystitis underwent 25 standard endonasal endoscopic DCR procedures, 10 with and 15 without mucosal flap preservation. 6 of these had concomitant sinonasal diseases for which they underwent septoplasty or functional endoscopic sinus surgery (FESS) or both, simultaneously or as staged procedures. Relief from epiphora and patency of the nasolacrimal fistula was assessed by nasal endoscopy and syringing of the lacrimal apparatus at 1 week, 3 weeks and 3 months postoperatively.Results Out of 18 patients who underwent only DCR, 17 patients (94.44%) had complete relief from epiphora. Out of 6 patients who underwent 7 DCRs with concomitant sinonasal surgery, 5 patients (85.71%) had complete relief from epiphora. Overall 23 out of 25 DCRs (92%) had complete relief. In 15 of the 25 procedures, mucosal flap was excised completely. In remaining 10 procedures, flap was trimmed, repositioned to cover exposed bone around the newly created nasolacrimal fistula. In either situation, only one patient each had partial block of the nasolacrimal fistula. Average duration of the surgical procedure of DCR was 18 min.Conclusion Endonasal endoscopic DCR is a viable alternative to external DCR, co-existing sinonasal diseases can be managed simultaneously, as may be required in 25% of cases. It can be performed under 20 min without mucosal flap preservation, mitomycin local application, silicon tube stenting or laser assistance and can still provide a good success rate (92%) with less complications.

UR - http://www.scopus.com/inward/record.url?scp=70350151375&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=70350151375&partnerID=8YFLogxK

U2 - 10.1007/s12070-009-0071-z

DO - 10.1007/s12070-009-0071-z

M3 - Article

AN - SCOPUS:70350151375

VL - 61

SP - 223

EP - 226

JO - Indian Journal of Otolaryngology and Head and Neck Surgery

JF - Indian Journal of Otolaryngology and Head and Neck Surgery

SN - 2231-3796

IS - 3

ER -