Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients

Abstract

Introduction Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective To evaluate the feasibility and the outcome of simultaneous bilateral Endo-DCR and its impact on the quality of life of the patients. Methods We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients.

Study the quality of life post endoscopic dacryocystorhinostomy

“…On comparing pre to post op general condition status, it was found that at pre op the mean condition score was 0.08±0.48 which was unchanged at post op. 11 It is similar to and supported by the study of Herzallah et al 12 in which the preoperative symptom scores of the patients for each side ranged between 12 and 80 (mean standard deviation [SD]: 38.23 +_ 15.7), with no significant difference in the symptom score between the right and left sides (p < 0.7). The postoperative symptom scores ranged between 0 and 50 due to the presence ofone failed case (mean SD: 5.4 +_ 12.9).…”

Simultaneous bilateral or sequential DCR? What to choose?

“…13–15 Bayraktar et al 15 reported high success and low morbidity rates for the bilateral endonasal approach. Herzallah et al 16 have identified improved quality of life in patients treated with bilateral simultaneous endonasal DCR, with equal SR and surgical outcome when compared to unilateral cases. As for the types of approach, endonasal or external, studies so far show equally good or sometimes better results achieved with the endonasal than with the external approach, with no increase in the complication rate.…”

“…13 In cases of bilateral NLDO the bilateral approach is gaining interest owing to reports of good results and a low rate of complications. 13–16 The aim of the present study was to compare the intraoperative and postoperative outcomes and results of simultaneous bilateral endonasal DCR with the other available surgery types/approaches in adults and children with NLDO.…”