Comparative study of external dacrocystorhinostomy with silicone tube intubation with endoscopic endonasal dacrocystorhinostomy in patients with nasolacrimal duct obstruction

Abstract

To compare the outcome following external dacrocystorhinostomy with silicon tube intubation with endoscopic endonasal dacrocystorhinostomy in patients with nasolacrimal duct obstruction. A prospective randomized comparative study conducted for 4years 6months in a teaching hospital with 26 cases of external dacrocystorhinostomy with silicon tube intubation and 15cases of endonasal dacrocystorhinostomy with a regular follow-up over 3years.Data regarding outcome and complications were analyzed and compared using chi-square test. Total of 41 patients was included in the study, 22 were females and 19 were males. The mean age for external dacrocystorhinostomy with silicon tube intubation and endoscopic dacrocystorhinostomy was 36.69 years and 39.33years respectively. Epiphora was the commonest presenting symptom (92.3%). Lid edema in postoperative period (3.8%) was the most common complication noted in external dacrocystorhinostomy with silicon tube intubation and bleeding, synechiae formation in endoscopic dacrocystorhinostomy (4.9%).The primary success rate was 100% with external dacrocystorhinostomy with silicon tube intubation, although 5.6% of patients had complications which were treatable and comparable to endoscopic dacrocystorhinostomy which was 90% (P value 0.0477 respectively) with two patients requiring revision procedure with successful outcome over follow-up. The outcome of both external dacryocystorhinostomy with silicon tube intubation and endonasal dacrocystorhinostomy were comparable, although complications were high in endonasal dacrocystorhinostomy (46.8%) with two requiring revision procedure due to failure and results were statistically significant. Therefore external dacrocystorhinostomy with silicon tube intubation can be considered as a primary procedure in patients with epiphora for better success rates and improvement in quality of life in pediatric case.