[Endonasal versus trans-canalicular endoscopic dacriocystorhinostomy using diode laser. Surgical techniques and outcomes]. / Dacriocistorrinostomía endoscópica endonasal frente a transcanalicular con láser diodo. Técnicas quirúrgicas y resultados.

OBJECTIVE: To evaluate the benefits and disadvantages of the endoscopic endonasal versus transcanalicular approaches using diode laser, and to compare their clinical outcomes. PATIENTS AND METHOD: A total of 127 patients were operated on, 80 of them with the endonasal approach (Group I) and 47 with the transcanalicular technique (Group II). OUTCOMES: Epiphora improved completely in 67 patients in Group I (83.7 %) while the other 13 (16.2 %) continued to present the same symptoms. In Group II, a successful result was achieved in 39 patients (82.9 %) and 8 (17 %) of them had to be re-operated because of the persistence of epiphora. CONCLUSIONS: The surgical outcomes are similar with both laser techniques. The main advantages of using diode laser are that it does not require general anaesthesia, the lower intra- and peri-operative morbidity, the lack of nasal packing and the greater ease of performing additional interventions if it fails. The only real disadvantage of laser procedures is the high cost.

Dacriocistorrinostomía endoscópica endonasal frente a transcanalicular con láser diodo. Técnicas quirúrgicas y resultados / Endonasal versus trans-canalicular endoscopic dacriocystorhinostomy using diode laser. Surgical techniques and outcomes

Objetivo: Valorar las ventajas y los inconvenientes de la vía endoscópica endonasal frente a las transcanalicular con láser diodo, así como comparar los resultados clínicos obtenidos. Material y método: Se intervino a un total de 127 enfermos, 80 por vía endonasal (grupo I) y 47 por vía transcanalicular (grupo II). Resultados: En el grupo I obtuvimos una desaparición completa de la epífora en 67 (83,7 %) casos, mientras que los 13 (16,2 %) restantes mantuvieron la sintomatología. En el grupo II, en 39 (82,9 %) se obtuvo un resultado positivo, y fue necesario reintervenir a los 8 (17 %) restantes por persistencia de epífora. Conclusiones: Los resultados obtenidos son equiparables con ambas técnicas quirúrgicas. Entre las ventajas del uso del láser se encuentran que no es necesario emplear anestesia general, la baja morbilidad peroperatoria y perioperatoria, la ausencia de taponamiento nasal y la mayor facilidad de realizar cirugía de rescate. El único inconveniente real del láser es su coste económico

Objective: To evaluate the benefits and disadvantages of the endoscopic endonasal versus transcanalicular approaches using diode laser, and to compare their clinical outcomes. Patients and method: A total of 127 patients were operated on, 80 of them with the endonasal approach (Group I) and 47 with the transcanalicular technique (Group II). Outcomes: Epiphora improved completely in 67 patients in Group I (83.7 %) while the other 13 (16.2 %) continued to present the same symptoms. In Group II, a successful result was achieved in 39 patients (82.9 %) and 8 (17 %) of them had to be re-operated because of the persistence of epiphora. Conclusions: The surgical outcomes are similar with both laser techniques. The main advantages of using diode laser are that it does not require general anaesthesia, the lower intra- and peri-operative morbidity, the lack of nasal packing and the greater ease of performing additional interventions if it fails. The only real disadvantage of laser procedures is the high cost