Endoscopic Vs External Dacryocystorhinostomy in Cases of Deviated Nasal Septum and/or Turbinate Hypertrophy

Document Type : Original Article

Authors

1 1. Assistant professor of Otorhinolaryngology, Faculty of Medicine of Boys, Al-Azhar University, Cairo, Egypt

2 Assistant professor, Ophthalmology Department, Faculty of Medicine of Boys, Al-Azhar University, Cairo, Egypt

3 Department of Otorhinolaryngology Faculty of Medicine of Boys, Al-Azhar University, Cairo, Egypt.

Abstract

Background: Dacryocystorhinostomy (DCR) is a surgical procedure that improves lacrimal system drainage by establishing a lacrimal drainage channel into the nasal cavity. External DCR and endoscopic DCR for the treatment of primary acquired nasolacrimal duct blockage in the context of deviated nasal septum and/or hypertrophy of the turbinates were compared.
Patients and Methods: This study included 60 patients complaining of epiphora due to nasolacrimal duct obstruction (NLDO). Patients were subdivided into two groups; group A included 30 patients submitted to endoscopic DCR and group B included 30 patients submitted to external DCR.
Results: The right eye was afficted more frequently than the left. Right eye involvement was 63.6 % and left was 36.4 %. Excessive intraoperative bleeding occurred in 5 cases (16.5%) in group A and 9 cases (29.7%) in group B. The difference was not statistically significant. (P value =0.39). 28 of 30 eyes (93.3%) that had endoscopic DCR surgery and 20 of 30 eyes (66.7%) that underwent external DCR surgery had a successful surgical outcome after six months. The difference was significant as p value = 0.009.
Conclusion: DCR is better performed by endoscopic approach especially in cases of deviated nasal septum and/or turbinate hypertrophy. Endoscopic DCR is a safe, less invasive method with superior outcomes compared to external DCR.

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