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Background:Primary antrochoanal polyp management is commonly done via middle meatal antrostomy which has a significant risk of recurrence. The prelacrimal recess approach is reported to minimize this risk. Aim: This study aims to compare the results of prelacrimal recess approach assisted middle meatal antrostomy with middle meatal antrostomy alone in the management of primary antrochoanal polyp. Patients and methods: A randomized prospective Comparative Study was performed on sixty patients with primary antrochoanal polyps in the period from October 2020 to June 2022. The patients were allocated randomly into two groups, group (A) 30 patients were surgically managed via only endoscopic middle meatal antrostomy, and group (B) 30 patients were subjected to endoscopic prelacrimal recess approach assisted middle meatal antrostomy. Postoperative follow-up was done subjectively and objectively over 6 months.Results: Age (p=0.4), sex (p=0.6), and lesion side (p=0.8) showed no statistically significant differences between the study groups, although mean operative duration was considerably shorter in Group A (25.2 ± 3.5) than Group B (37.7 ± 4.2) (p>0.001). Regarding the complications, there was no statistically significant difference between the two study groups regarding occurrence of Nasal obstruction(p=0.3) and Synechia(p=0.1), while recurrence rate was statistically significantly higher among group A than group B (p=0.03). Conclusion: Prelacrimal recess approach assisted middle meatal antrostomy is a unique method for removing antrochoanal polyps to prevent its recurrence with reasonable operative time and few postoperative problems.

Background: Epiphora is defined as watering of the eye due to imperfect drainage of tears through lacrimal passages. It may result from a wide variety of causes, the commonest cause is nasolacrimal duct obstruction (NLDO), which may be congenital or acquired. AcquiredNLDO may be primary or secondary.Dacryocystorhinostomy (DCR) is an operation that creates a lacrimal drainage pathway into the nasal cavity to facilitate drainage of the previously obstructed excreting system. Aim of the work:The aim of this study is to compare endoscopic DCR and balloon catheter dilation in treatment of nasolacrimal duct obstruction. Patients and methods; A Prospective randomized comparative Study was conducted on 30 patients .15 cases underwent endoscopic DCR while the other cases underwent balloon catheter dilation. Data were analyzed and compared using Z, Chi-square and Fisher exact test. Results: The balloon catheter dilatation is a safe and minimally invasive technique but the endoscopic DCR has a high success rate. Conclusion: The two techniques are acceptable alternatives. The choice of surgery should depend upon patient's preference and availability of resources.