Specific features of endoscopic dacryocystorhinostomy – case report

Abstract

OBJECTIVE. The aim of the study was to evaluate the endoscopic dacryocystorhinostomy (DCR) with some particularities and its advantages over external DCR. MATERIAL AND METHODS. We evaluated 3 female patients (age range 35-84 years) diagnosed with chronic dacryocystitis - lacrimal sac abscess (2 cases) and lacrimal sac fistula (1 case). All patients presented a history of repeated episodes of acute dacryocystitis initially treated with broad spectrum antibiotics by the ophthalmologist. The evaluation protocol consisted in cranio-facial CT scan or MRI for the evaluation of the lacrimal sac and nasal structures, an ophthalmologic examination with the catheterization of the superior and inferior lacrimal punctum with a light probe to verify the permeability of the lacrimal pathway, and the Jones test with fluorescein to receive information about the common lacrimal path. Lacrimal syringing with regurgitation of fluid from the opposite punctum was the only criteria to decide the surgery. In all three cases we performed an endoscopic DCR, with stent insertion in two cases and a laco-dacryo-rhinostomy in one case. In only one case a reintervention was needed 12 months later. CONCLUSION. The endoscopic DCR, with its different particularities, is a safe surgical procedure with a low rate of complications, being the treatment of choice for the treatment of nasolacrimal duct obstruction.