EVALUATION OF EXTERNAL DACRYOCYSTORHINOSTOMY- A HOSPITAL BASED PROSPECTIVE STUDY

Abstract

Background: Chronic dacryocystitis occurs usually due to obstruction of lacrimal passage at the junction of the lacrimal sac and the nasolacrimal duct or within the bony nasolacrimal duct.

Objectives: This study aimed to evaluate the role of mechanical Dacryocystorhinostomy (DCR) to restore the ?ow of tears into the nose from the lacrimal sac when the nasolacrimal duct does not function.

Methods: It is a hospital based prospective study performed on 60 patients of age group between 10-50 years in four months. Patients included in the study had nasolacrimal duct obstruction and not undergone previous lacrimal surgery. The technique involved anastomosis of nasal mucosal and lacrimal sac flaps and a large bony ostium. Success was defined as anatomical patency with fluorescein flow on nasoendoscopy and patency to lacrimal syringing.

Results: Sixty patients (36 males and 24 females) with the mean age of 23 years underwent mechanical endonasal Dacryocystorhinostomy (DCR) in a same-day surgery. No complications were detected including hearing loss, otorrhea and wound complication with no retraction pocket or displaced graft during follow-up period. The grafts take rate was 90% (six cases of unilateral incomplete closure). The mean of air-bone gap overall improved from 13.88 dB preoperatively to 9.16 dB postoperatively (p < 0.05).

Conclusion: Unilateral external transcanal cartilage tympanoplasty can be considered as a safe minimally invasive procedure that can be performed in a same-day surgery. It reduces the cost and operation time and is practical with a low rate of postoperative complications.

Keywords: Atrophic Rhinitis, External Dacryocystorhinostomy (DCR), Hearing Loss, Lacrimal Sac, Nasolacrimal Canal, Otorrhea.