Comparative study of external and endoscopic endonasal dacryocystorhinostomy for the treatment of chronic dacryocystitis

Abstract

Introduction: Dacryocystorhinostomy (DCR) is the treatment of choice for Chronic Dacryocystitis. Although external DCR is classic method for this surgery, endoscopic DCR is evolving as an equally effective alternative in recently even in Albania. Objective: The study consist in compare the surgical outcome of external DCR and endoscopic endonasal DCR for the treatment of Chronic Dacryocystitis. Method: This study was done in a private clinic Albanian Eyes Center and Department of Ophtalmology in the Hospital Center "Mother Theresa" University Hospital Center in Tirana Albania, from January 2011 to May 2012. with a total of 100 patients . They were selected for DCR surgery. Among those 50 patients underwent endoscopic endonasal DCR and 50 of them under went patients external DCR. Surgical success consist in reduction in epiphora and failure was defined as no symptomatic reduction of epiphora and/or inability to irrigate the lacrimal drainage system postoperatively. Results: Mean age of the patients were 35-40 years old. 65% of the patients were females and 35% of the patient were males. The result showed that both surgical approaches had almost similar success rate (endoscopic DCR 90% versus external DCR 92%). Complication rate was low and no appreciable difference in complication was marked in both types of surgery. 16% in endoscopic DCR group and 14% in external DCR group had moderate bleeding. Two patients (15%) of endoscopic surgery required septoplasty. In most of the cases the tubes were removed after 3 months. The failure rate in 22% for endoscopic DCR and 20% for external DCR. Conclusions: Surgical outcome of both endoscopic and external DCR for Chronic Dacryocystitis was quite satisfactory. The complication rate was low. Endoscopic surgery might have an advantage of not having any external scar and shorter surgical time, higher patient satisfaction and it can be done in acute cases.