The Agger nasi DCR: a new technique for endoscopic dacryocystorhinostomy

Abstract

Purpose Endoscopic dacryocystorhinostomy (DCR) is the gold-standard procedure for the treatment of nasolacrimal duct obstruction, aiming to open the lacrimal sac directly into the nasal cavity and thus re-establish drainage of the tear pathways. The present study proposes a new surgical technique that relates the agger nasi cell (AN) to the lacrimal sac and advocated for its systematic opening. Methods We analyzed 36 patients who underwent DCR using the AN as a key landmark over a 2-year period. The criteria for assessment of surgical success were patency of the ostium that communicates the lacrimal sac with the nasal cavity and absence of significant epiphora according to the Munk scale. Results Patency of the drainage ostium was observed in the late postoperative period in 100% of cases. Epiphora were absent in 86.48% of those cases followed for at least 6 months after surgery. Conclusion Agger nasi dacryocystorhinostomy (AN-DCR) involves opening the AN as a landmark for wide and complete exposure of the lacrimal sac. This approach is a safe and highly effective method that yields good postoperative outcomes.