Endoscopic transnasal dacryocystorhinostomy without stenting: results in 64 consecutive procedures.

ABSTRACT

Dacryocystorhinostomy allows by-passing saccal and post-saccal stenoses and has traditionally been performed via an external approach, namely, external dacryocystorhinostomy. Over the past two decades, advances in endoscopic equipment have led to the widespread use of the endoscopic transnasal approach to the lacrimal pathway. A retrospective evaluation has been made of personal success rates in endoscopic dacryocystorhinostomy without stenting in 56 patients (15 male, 41 female) treated for nasolacrimal duct obstruction (48 unilateral, 8 bilateral). Of these, 53 were primary endoscopic dacryocystorhinostomy and 11 procedures were revisions of external dacryocystorhinostomy. A total of 64 endoscopic dacryocystorhinostomies were performed. Mean follow-up was 37.3 months (range 12-84 months). The success of surgery was defined by resolution of signs (epiphora and dacryocystitis) and objectively by endoscopic evaluation of the rhinostomy on routine follow-up. Results from patients undergoing primary endoscopic dacryocystorhinostomy were better than those for revision of external dacryocystorhinostomy with overall anatomical and functional results of 94.3% and 90.9%, in our series. The present study confirms that endoscopic dacryocystorhinostomy without stenting is effective for the treatment of nasolacrimal duct obstruction. The endoscopic approach allows simultaneous treatment of associated anatomic anomalies and sino-nasal disorders. Results obtained confirm that a functionally patent dacryocystorhinostomy can be achieved without the need for routine nasolacrimal stenting..