Systematic Review and Meta-Analysis on Outcomes for Endoscopic Versus External Dacryocystorhinostomy

Huang, June; Malek, Joanne; Chin, David; Snidvongs, Kornkiat; Wilcsek, Geoff; Tumuluri, Krishna; Sacks, Raymond; Harvey, Richard J.

doi:10.3109/01676830.2013.842253

Cited by 126 publications

(111 citation statements)

References 18 publications

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“…In another study, Davies et al (16) reported that in their series of 72 patients, only 4.2% of the patients had visible scars, no remarkable scar was formed in any patients, and none of the patients were unhappy with his/her scar. In a meta-analysis, 554 EXT-DCR procedures were evaluated and the unacceptable rate of scarring for the patient was found to be 10.8% (6). In our study, it was reported that no visible scarring remained in (37/43) 86.1% of the patients who underwent EXT-DCR and a very small scar remained in (6/43) 13.9% of the patients.…”

Section: Discussionmentioning

confidence: 58%

“…The correction of epiphora and the prevention of dacryocystitis episodes can be considered as the success criteria in DCR. Very different success rates have been reported in the literature for both methods (4)(5)(6)(7)(8)(9). In a study, the authors suggested that the reason for such varying success rates was that there were no standard and objective methods to measure the results.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of Endoscopic and External Dacryocystorhinostomy Results and Analysis of Patients’ Satisfaction

Somuk

Alim

Sapmaz

et al. 2016

Turk Arch Otorhinolaryngol

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Objective: Comparison of endoscopic and external dacryocystorhinostomy (DCR) results and evaluation of patients' satisfaction.Methods: Forty six (35 females and 11 males) patients who underwent endoscopic DCR and 43 (37 females and six males) who underwent external DCR were included. Surgical success was objectively and subjectively assessed. The nasolacrimal duct was irrigated by a saline solution, and the saline solution was objectively visualized by endoscopy from the nose. Subjective assessment was performed asking the patients' epiphora. In addition to evaluating the success of the operation, satisfaction and result surveys were administered to the two groups.Results: There was no statistically significant difference between the two groups in terms of age and sex (respectively p=0.486, p=0.23). However, the number of females was higher than the number of males in the two groups, and the difference was statistically significant (endoscopic-DCR p=0.01, external-DCR p=0.001). There was no statistically significant difference between the two groups in terms of postoperative bleeding and punctum damage. The success rate was 84.7% in the endoscopic DCR group and 90.6% in the external DCR group. There was no statistically significant difference in the success rate between the two groups (p=0.397). The survey results revealed that there was no statistically significant difference between the two groups in terms of patient satisfaction (p=0.397). Conclusion:The results of many studies in the literature show operation success rates between the two groups that are similar to ours. Both techniques have advantages and disadvantages. Independent of the preferred procedure, our results show that functional success mainly determines patient satisfaction.

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Section: Discussionmentioning

confidence: 58%

Section: Discussionmentioning

confidence: 99%

Comparison of Endoscopic and External Dacryocystorhinostomy Results and Analysis of Patients’ Satisfaction

Somuk

Alim

Sapmaz

et al. 2016

Turk Arch Otorhinolaryngol

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“…Whereas, success rates for En-DCR reported vary from 74 to 100%, but may be complicated by nasal bleeding, nasal osteotomy scarring, granuloma, osteotomyturbinate/septal synechiae, CSF-rhinorrhea, and damage to the orbital contents. [2][3][4][5][6][7] Purpose of our study is to compare and analyze the surgical outcome of both Ex-DCR and En-DCR, in terms of their success, failure, and complications in a retrospective way, in our tertiary referral center of northern India. Patients and Methods: After obtaining approval from the Hospital medical ethics committee, retrospective data were collected, on patients who underwent DCR, for a period of two years from October 2013 to September 2015, at our medical college of north India.…”

mentioning

confidence: 99%

Comparison of external and endoscopic endonasal dacryocysto-rhinostomy: a hospital based retrospective study

2016

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“…12 No adjunctive procedures such as septoplasty or polypectomy were performed on any of our patients. In our opinion, if such procedures are deemed necessary they should only be performed by an otolaryngologist, as recommended by Kim et al 14 While some studies have demonstrated that such procedures improve success rates of END-DCR by improving access to the surgical site, 15 we have not found access to be difficult with decongestion of the lateral wall of the nose, after reflection and removal of the nasal mucosa.…”

Section: Discussionmentioning

confidence: 99%

“…[8][9][10][11] A meta-analysis conducted in 2014 comparing the success rates of END-DCR with EXT-DCR, where success was defined as, 'resolution of symptoms and/or anatomical patency', concluded that the overall success rate of END-DCR (excluding laser-assisted approaches) was 87%, which was the same as that of EXT-DCR. 12 The authors point out that this is less than the 'oft-quoted 90-95% from case series and is likely to reflect the bias in such lower level evidence'.…”

Section: Introductionmentioning

confidence: 87%

Anatomical and subjective success rates of endonasal dacryocystorhinostomy over a seven-year period

Beshay

Ghabrial

2016

Eye

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Purpose Endonasal dacryocystorhinostomy (END-DCR) is a relatively novel approach that has recently been shown in some studies to provide similar success rates to the more traditional external approach for the treatment of nasolacrimal duct obstruction (NLDO). However, a range of success rates using this approach are reported within the literature and the majority of oculoplastic surgeons are still favouring the external approach. The purpose of this study was to review the anatomical and subjective success rates of END-DCRs performed over a 7-year period. Patients and methods We provide a review of the success rates of 288 END-DCRs for the treatment of acquired NLDO performed over a 7-year period by a single oculoplastic surgeon in Sydney, Australia. We describe the operative technique used and define anatomical success as demonstrated patency of the nasolacrimal drainage system at 10 weeks postoperatively while subjective success is defined as complete resolution or significant improvement of symptoms as reported by patients at the same time point. Results In our study, we were able to demonstrate that out of 288 END-DCRs, an average anatomical success rate of 89.6% and an average subjective success rate of 81.3% were achievable. Conclusions We conclude that the success rates using our endonasal approach remain similar to those obtained using the external approach, as reported within the literature, and may be considered as a primary treatment option for acquired NLDO.

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Systematic Review and Meta-Analysis on Outcomes for Endoscopic Versus External Dacryocystorhinostomy

Abstract: DCR is a procedure with high success rates. Endoscopic procedures differ greatly by technique with EM-DCR offering comparable results to EXT-DCR, without the risk of cosmetically unacceptable scars.

Cited by 126 publications

References 18 publications

Comparison of Endoscopic and External Dacryocystorhinostomy Results and Analysis of Patients’ Satisfaction

Comparison of Endoscopic and External Dacryocystorhinostomy Results and Analysis of Patients’ Satisfaction

Comparison of external and endoscopic endonasal dacryocysto-rhinostomy: a hospital based retrospective study

Anatomical and subjective success rates of endonasal dacryocystorhinostomy over a seven-year period

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