Comparative Study of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy

Abstract

A prospective study on 50 cases of chronic dacryocystitis was done to see outcome of management by endoscopic dacryocystorhinostomy (DCR) in Indian population and to look for its advantages or disadvantages over external-DCR. Effect of mitomycin-C was also evaluated in endoscopic DCR cases. Dacryocystitis was diagnosed on the basis of clinical examination by doing regurgitation test and lacrimal syringing. These patients were divided into two groups: group I consisted of those 25 subjects who were planned for endonasal endoscopic DCR and group II of those 25 subjects who underwent external-DCR in ophthalmology department. Of all the cases, maximum number of cases was in the age group of 21 to 35 years, 27 (54%) cases, 88% were females and 12% were males. External-DCR required a relatively longer surgical duration of an average 65 minutes as compared to 35 minutes for endonasal DCR. Average hospital stay for patient in group I was 3 days and it was 7 days in group II. There were minimal intraoperative complications in endoscopic procedure as compared to external-DCR group. Average follow-up was 6 months. Primary success rate was 96% in both the groups. Thus, it was concluded that both the procedures represent good alternatives for the treatment of primary nasolacrimal sac or duct obstruction or chronic dacryocystitis, endoscopic DCR having advantage of less complications and less traumatic. Mitomycin-C was found to be helpful in reducing fibrosis.