Comparison of External and Endonasal Dacryocysto - Rhinostomy in Acquired Nasolacrimal Duct Obstruction

Abstract

AIM:To compare the success rate and complications of external dacrycystorhinostomy with that of endonasal dacryocystorhinostomy. STUDY DESIGN: Prospective randomized comparative study. MATERIAL AND METHODS: Sample Size: The study comprises of 60 eyes of 54 consecutive patients with chronic dacryocystitis of which 28 patients underwent external dacryocystorhinostomy and 26 patients underwent endonasal endoscopic dacryocystorhinostomy. All the patients were selected by simple random method. INCLUSION CRITERIA: All symptomatic epiphora cases diagnosed for primary acquired nasolacrimal duct obstruction by the means of lacrimal sac syringing were taken for the study. Nasal endoscopy was done in all the patients to rule out any associated nasal pathology. EXCLUSION CRITERIA: Patients with nasal and canalicular pathology, bleeding disorders, uncontrolled hypertension and diabetes mellitus were excluded. STATISTICAL ANALYSIS: The data was analysed by the SPSS software version 16.0. Chi Square and Fisher's exact test were used to compare the assumption between the two groups. P value less than 0.05 was considered as significant. RESULTS: The overall primary success rate of external dacryocystorhinostomy was 93.33% and that of endonasal dacryocystorhinostomy was 90% at 3 months after surgery, but this difference was not statistically significant (P=1.0). CONCLUSION: External DCR remains as the gold standard in the treatment of nasolacrimal duct obstruction for a successful outcome with minimal complications.

Success Rate of External Dacryocystorhinostomy With and Without Stent

“…In terms of success rate, previous studies have shown a higher rate of success of external DCR than endoscopic DCR. In the prospective randomized comparative study of Nailwal et al [ 18 ], the overall success rate of external dacryocystorhinostomy after three months of surgery was 93.33%, whereas that of endonasal dacryocystorhinostomy was 90%, but this difference was not statistically significant (p=1.0). Dasgupta et al [ 19 ] reported the same findings, with an overall success rate of 92.80% for DCR surgery.…”

Comparative Study between Endoscopic Dacryocystorhinostomy and Balloon Catheter Dilatation in Treatment of Chronic Nasolacrimal Duct Obstruction

“…It may result from a wide variety of causes, the commonest cause is nasolacrimal duct obstruction (NLDO) (2) , which may be congenital or acquired. Acquired NLDO may be primary or secondary (3) .…”