Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction: long-term results in 91 procedures.

BACKGROUND: The purpose of the present study was to evaluate long-term outcomes of endoscopic dacryocystorhinostomy (DCR) using a drill without the use of mucosal flaps. Ninety one procedures in eighty seven patients were reviewed. All patients showed epiphora, caused by primary or secondary nasolacrimal obstruction. METHODOLOGY: All patients underwent preoperative evaluation (irrigation and probing of the lacrimal drainage system, fluorescein tests, computerized tomography scan of the paranasal sinuses, dacryocystography and endoscopic examination of the nasal cavity). In 19 patients further intranasal procedures were conducted simultaneously with DCR (10 FESS, 2 septoplasties, 5 functional endoscopic sinus surgery (FESS) and septoplasties, 2 septoplasties and turbinoplasties). Stents were placed intraoperatively and removed 4 to 12 weeks, postoperatively. Postoperative follow-up ranged between 12 and 24 months. RESULTS: Long-term success was achieved in 87/91 procedures. No major complications were observed. Failure was caused by granulation tissue formation in three patients and inappropriate stent removal in one patient. CONCLUSION: The success rate achieved is comparable to success rates of external DCR.