Sinonasal effects of external dacryocystorhinostomy

Abstract

Objective External dacryocystorhinostomy is thought to cause mucociliary dysfunction by damaging the mucosa, in turn affecting ciliary activity and mucus quality. This study investigated the effect of external dacryocystorhinostomy on sinonasal function. Methods Patients scheduled for unilateral external dacryocystorhinostomy who underwent endoscopic nasal examination and paranasal sinus computed tomography were included in this study. A saccharine test was performed on the planned surgical side and the mucociliary clearance time was determined. The sinonasal quality of life was measured in all patients, pre-operatively and at six months post-operatively, using the Sino-Nasal Outcome Test-22. The Lund–Kennedy endoscopic score was also determined in all patients, both pre- and post-operatively. Results The study comprised 28 patients (22 females and 6 males). A statistically significant difference was found between the pre- and post-operative saccharine test results (p = 0.006), but not between the pre- and post-operative Sino-Nasal Outcome Test-22 scores (p > 0.05). Conclusion This study is one of only a few to investigate the effect of external dacryocystorhinostomy on sinonasal function. The results showed that external dacryocystorhinostomy impairs mucociliary clearance. The surgical procedure is well tolerated and does not significantly change nasal symptom scores.

Efficacy of Endoscopic Endonasal Common Canaliculorhinostomy for Chronic Dacryocystitis with Small Lacrimal Sac in the Treatment of Failed Patients After EE-DCR

“…The existing surgical methods include lacrimal intubation, YAG laser , external dacryocystorhinostomy (Ex-DCR) and EE-DCR [3][4]. For more than 100 years, Ex-DCR has been regarded as the "gold standard" for the treatment of chronic dacryocystitis, but it can't meet people's growing medical needs due to the shortcomings of facial skin scar, large trauma, affecting the function of "tear pump" and unable to deal with nasal complications at the same time [5][6][7]. Over the past 10 years, with the continuous improvement of endoscopic imaging system, ENT micro power system and other medical equipment, EE-DCR is highly recommended in clinic because of its incomparable advantages of Ex-DCR, such as no facial skin incision, minimally invasive and does not affect the function of "tear pump", simultaneous treatment of nasal complications, et al However, so far, the e cacy of EE-DCR has been reported differently, and its losers are not rare [8][9][10].…”