Primary Powered Endoscopic Dacryocystorhinostomy in the Setting of Acute Dacryocystitis and Lacrimal Abscess

Abstract

Primary powered endoscopic dacryocystorhinostomy is an effective modality in the management of acute dacryocystitis and lacrimal abscess, and result in rapid resolution of the disease.

Long‐term outcomes of powered endoscopic dacryocystorhinostomy in acute dacryocystitis

“…All cases were operated during the acute stage by a single surgeon ( m.j.a. ) using the techniques described earlier . In brief, incisions are taken 10 mm above the axilla of the middle turbinate and extended anteriorly for 10 mms.…”

“…Acute dacryocystitis is defined as “a medical urgency which is clinically characterized by rapid onset of pain, erythema and swelling, classically below the medial canthal tendon with or without pre‐existing epiphora mainly resulting from the acute infection of the lacrimal sac and perisac tissues.” If left untreated or inadequately managed, it can lead to complications such as orbital cellulitis, orbital abscess, superior ophthalmic vein thrombosis, and meningitis . One of the major limiting factors in performing an external dacryocystorhinostomy (DCR) in acute dacryocystitis is the degree of inflammation, which makes the surgical procedure difficult and may subsequently impact the outcomes .…”

“…One of the major limiting factors in performing an external dacryocystorhinostomy (DCR) in acute dacryocystitis is the degree of inflammation, which makes the surgical procedure difficult and may subsequently impact the outcomes . In contrast, the role of endoscopic DCR during the acute phase of dacryocystitis is increasingly being recognized as a safe alternative that decreases morbidity and hastens recovery . With the establishment of endoscopic DCR as an equally effective modality for the treatment of persistent and complex congenital nasolacrimal duct obstruction (CNLDO), recurrent pediatric acute dacryocystitis is also being recognized as one of the indications for surgery during the acute phase .…”

Time taken for superior osteotomy in primary powered endoscopic dacryocystorhinostomy: is there a difference between an ultrasonic aspirator and a mechanical burr?

“…[2][3][4] The specifics with regard to superior osteotomy are described here. Following elevation of the mucosal flap off the lateral wall, the frontal process of maxilla and its junction with lacrimal bone are exposed.…”

Management of Lacrimal Pathway Obstructions: A Deliberation

“…We have shown the short-term and long-term benefits of performing a powered endoscopic DCR in the setting of acute dacryocystitis and even in a lacrimal abscess. 43,44 Ruchi Goel: In acute dacryocystitis, the earlier the laser DCR is done, the faster is the recovery. The traditional approach of giving systemic antibiotics with drainage of pus prolongs the morbidity.…”