Primary Endonasal Endoscopic Powered Dacryocystorhinostomy for Low Obstruction of the Lacrimal Excretory System in Adult Patients: A 5-Years Experience
(2020) HSOA Journal of Otolaryngology, Head & Neck Surgery — Vol. 5, p. 040 [1-6] (2020)
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- (en) PURPOSE: The aim of this retrospective study was to describe the outcomes of powered endonasal endoscopic dacryocystorhinostomy(DCR) performed for symptomatic low lachrymal obstruction in adult patients over a 5-year period by the same surgeon. METHODS: Retrospective study. PATIENTS: Patients suffering from a low obstruction of the lachrymal system documented by paraclinical investigations treated in the ENT department of CHU UCL Namur between September 2011 and September 2016. RESULTS: In total, 128 procedures were performed for 111 patients. The mean age at the time of surgery was 62.3 years (range: 18.1-93.0 years). There were 93 women and 18 men, and the mean follow-up duration was 40.5 months (range: 12.1-54.47 months. Aetiologies for the lacrimal obstruction included primary acquired nasolacrimal duct obstruction (PANDO; n=123), LeFort fractures (n=3), and radiotherapy/chemotherapy (n=2). Epiphora only (n=98), chronic purulent discharge (n=30), and acute dacryocystitis (n=4)were major symptoms. The stoma remained patent in115 of the 128 (89.8%) procedures, while111 (86.7%) procedures resulted in complete symptom resolution. Persistence of tearing without infection was observed after 17 (13.3%) procedures, with revision surgery performed in 13(10.1%) cases. CONCLUSION: Endoscopic endonasal powered DCR is an effective surgery for primary saccal and post-saccal lachrymal obstruction in adults. The success rate is high and very competitive to that after an external approach. Powered instrumentation is a nice tool to make the resection of the bony part of the frontal process of the maxillary easier and quicker particularly in case of very thick bone. The postoperative morbidity is very low; The rehabilitation is fast. Septoplasty or sinus surgeries can be performed in the same operating setting when required with no deleterious impact on the success rate of DCR.
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Renward, W., De Dorlodot, C., & Eloy, P. (2020). Primary Endonasal Endoscopic Powered Dacryocystorhinostomy for Low Obstruction of the Lacrimal Excretory System in Adult Patients: A 5-Years Experience. HSOA Journal of Otolaryngology, Head & Neck Surgery, 5, 040 [1-6]. https://doi.org/10.24966/OHNS-010X/100040 (Original work published 2020)