Comparison of endocanalicular laser dacryocystorhinostomy with and without endonasal procedures

Abstract

Based on our increased anatomical success rates, concomitant endonasal procedures may help increase success rate in endocanalicular diode laser DCR cases.

Comparison of endonasal dacryocystorhinostomy (DCR) versus endocanalicular diode laser DCR for the treatment of nasolacrimal duct obstruction

“…Bone-cutting forceps are not required because the diode laser can be applied to ablate the bone. [25] The laser systems achieve satisfactory coagulation and postsurgical edema is not seen with diode laser application. This advantage provides lesser intraoperative bleeding and results in faster wound healing.…”

“…[2] Wormald et al [26] showed that the major portion of the sac was situated above the middle turbinate and that inadequate bone removal above the middle turbinate is an important reason for failure in all treatment approaches to nasolacrimal ductus obstruction. [25] The endocanalicular approach usually creates smaller neo-ostia than the external and endonasal approaches and this is correlated with lower success rates of endocanalicular DCR. [30] Other reasons for failure of endocanalicular diode laser application are related to formation of synechia between the lateral surface of the middle turbinate and the medial surface of the lateral wall of the nose and the granulation tissue obstructing the neo-ostium.…”

“…[30] Other reasons for failure of endocanalicular diode laser application are related to formation of synechia between the lateral surface of the middle turbinate and the medial surface of the lateral wall of the nose and the granulation tissue obstructing the neo-ostium. [25] In one study, a gel foam patch was packed to keep the neo-ostium open throughout the healing period after endonasal DCR. [31] In another study, the uncinate process was evaluated as a landmark and unciformectomy was found to affect the success rate and complications of endonasal DCR.…”

Endocanalicular laser dacryocystorhinostomy (ECLDCR)

“…Dear Editor, We read with great interest the controversial report by Basmak et al on the improvement of success rates in initial partial middle turbinectomy (MT) with ECLDCR [1]. The main advantage of ELDCR is the reduction in complications of external and endonasal DCR and improvement of cosmetics.…”

“…According to Basmak et al [1], partial MT was done for the enlargement of the primary ostium; however, the average diameter of ostium was not mentioned in this article. The diameter of primary external DCR ostium (approximately 1 cm) will be very reduced after the healing process and will measure between 1.8 and 2 mm [8,9].…”