Primary endoscopic dacryocystorhinostomy

Abstract

Many patients present to the specialist complaining of tearing. Although a variety of etiologies have been associated with epiphora, nasolacrimal duct obstructions are one of the most common. Blockage of the nasolacrimal system can be associated with chronic tearing, discharge, and irritation, which are often quite debilitating. A dacryocystorhinostomy (DCR) creates an alternate passageway between the lacrimal sac and nasal cavity, thus bypassing the obstructed nasolacrimal duct. DCR can be performed either by an external approach that utilizes a cutaneous incision, or through an endoscopic approach, which includes an incision in the nasal cavity. An endonasal approach was initially described by Caldwell in 1893 [1]. Shortly thereafter, Toti described an external approach in 1904 [1].