Endoscopic Endonasal Dacryocystorhinostomy: Prevention of Neo-Ostium Obstruction Using Nasal Mucosal Flap / 대한이비인후과학회지

ABSTRACT

BACKGROUND AND OBJECTIVES: The success rate of endoscopic endonasal dacryocystorhinostomy (DCR) is not satisfactory enough compared to that of external approach because the newly made ostium is easily obstructed due to granulation tissue formed around the small ostium. The objective of this study is to describe a new technique of an endoscopic DCR which minimizes the stenosis of neo-ostium and to report its success rate. MATERIALS AND METHOD: Twenty patients who had undergone endoscopic DCR with the diagnosis of proximal nasolacrimal duct obstruction were investigated retrospectively. All procedures were done by the same surgeon. The surgical technique includes elevation of mucosal flap, full sac exposure using diamond drill, and design of mucosal flap to cover the denuded bone and approximate with opened sac mucosa. Postoperative symptom improvement and endoscopic finding of the neo-ostium were evaluated. The mean duration of follow-up was 8 months. RESULTS: Ninety percent success rate was noted without any serious complications. Obstruction of the neo-ostium with granulation tissue was observed in two patients. CONCLUSION: Endoscopic DCR using mucosal flap after full sac exposure gives satisfactory success rate without any serious complications.