Intubation in routine dacryocystorhinostomy: why we do what we do

Abstract

The role of intubation in routine dacryocystorhinostomy (DCR) surgery is unclear, with there being little evidence in favour of this practice, which appears to have largely come about as a result of history, anecdote and the evolution of DCR surgery. In this paper, a brief history of intubation in DCR surgery is presented and the evidence base is analysed.

External Dacryocystorhinostomy With or Without Double Mucosal Flap Anastomosis

“…However, there are some controversies associated with this procedure in techniques with flaps, 14,15,22,23 and no study has verified the efficacy of stents in ex-DCR without flap anastomosis. Premature stent loss did not cause recurrence in the current study, and another study of ex-DCR without flap anastomosis without stent insertion also showed a success rate similar to that of the current study.…”

Endoscopic guided single self-linking silicone stent in pediatric external dacryocystorhinostomy

“…Though the use of routine silicone intubation in DCR is itself controversial, nonetheless several surveys have shown that the practice of routine intubation varies from 59.2% to 93.5% (12,13). If we consider unfavourable situations such as poor flap creation, pericanalicular fibrosis and small sac, these numbers would be much higher.…”

Eight-flap anastomosis in external dacryocystorhinostomy

“…However, there were some reports that disputed the effectiveness of stents 19 20. DCR without intubation has also been reported as a useful technique 19 20. In the future, a prospective randomised study is needed to investigate the necessity of stents for 8-flap ex-DCR.…”