Evaluation of a DCR Ostium and DOS Scoring

Abstract

Dacryocystorhinostomy (DCR) is common surgery employed for the management of nasolacrimal duct obstruction and chronic dacryocystitis with a high success rate [1–8]. However, the failure rates can occur from 4 to 13 % [1, 9–11]. Many causes of failures can be attributed to ostium, the most common being scarring and cicatricial closure of the osteotomy site [9–12]. The other causes related to ostium include inadequate size, inappropriate location, intervening ethmoids, DCR to air cell, membranes over the internal common opening, granulomas, and sump syndrome [10, 12, 13]. Numerous studies in the past have focused on the size and measurement techniques of the ostium and patency tests [14–22]. It is amply evident that many finer physical and functional details of the ostium need to be evaluated postoperatively in an orderly manner to appreciate pathological behaviors early on and institute corrective measures toward prevention or treatment. This chapter presents a DCR ostium protocol for a detailed evaluation and also the DCR ostium or the DOS to standardize the evaluation.