Mechanical Endonasal Dacryocystorhinostomy Versus External Dacryocystorhinostomy

Abstract

The success rate of MENDCR (93.5%) compares favorably with that of standard external DCR (95.8% in this study). MENDCR relies on the creation of a large ostium and mucosal flap apposition. A larger, randomized prospective trial is needed to fully assess the efficacy of this new technique.

Endoscopic dacryocystorhinostomy with conventional instruments: results and advantages over external dacryocystorhinostomy

“…Although there are reports of successful DCR with powered instrument [3] and laser DCR [7] but all the cases underwent non powered and non-laser DCR. The success rate of endonasal DCR has been reported to be very high and as good as external DCR [8,9]. Our success rate is as high as 96%.…”

Lacrimal drainage obstruction and dacryocystorhinostomy in children

“…Previously reported studies of paediatric DCR patients showed that 35-50% of cases were of unresolved congenital NLDO, with the remainder including punctal agenesis, lacrimal fistula, post-traumatic NLDO, and post-inflammatory canalicular obstruction. 10,11,14 A similar distribution was observed in our series in which 56 cases (54.8%) were of refractory primary congenital NLDO, and the others were of different etiologies. It should be emphasized that underlying pathology, approaches and outcomes of puncta/canaliculi dysgenesis, and lower lacrimal outflow system are quite different .…”

“…Radiation therapy slows or prevents the normal tissue contraction that occurs around the Jones tube, and extensive trauma or scar tissue can cause the tube to be hyper mobile for a prolonged period of time. 35 Children have a tendency for a vigorous repair process producing scar tissue, 11 which may be associated with a more mobile tube and associated migration.…”

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

“…The non-laser EES-DCR was performed mainly as described by Tsirbas et al 4,10 and Wu et al 39 A mixture of 2 ml of 2% lidocaine and epinephrine (1 : 1 00 000) was injected into the lateral nasal wall in addition to an external anterior ethmoidal nerve block and an infraorbital nerve block. Under direct visualization with a 451 4-mm endonasal endoscope (Karl Storz, Tuttlingen, Germany), the lateral nasal mucosa was incised in the area of the lacrimal sac fossa and removed.…”

“…The success rate for EES-DCR, however, varies markedly from 54 to 96%. [1][2][3][4][5][6][7][8] Numerous modifications have been developed to promote ostial patency, ranging from various methods of producing the nasal mucosal and/or lacrimal sac flaps, 2,4,[9][10][11][12] varying the size of the bony ostium, 4,[12][13][14] lacrimal sac incision, 15 to stenting. 16,17 Nevertheless, ostial closure or obstruction still occurs, mostly due to excessive scars/synechia or granulation formation at the ostium.…”