Endonasal Dacryocystorhinostomy - Our Experience

Abstract

In this study we present our experience with 32 patients, operated with one team consisting of (Nasal surgeon and
Ophthalmologist) in Tripoli Medical Center, Tripoli, Libya.
In the last two decades the less invasive endonasal technique (WEST method), has replaced the classical external
approach (TOTI method) in many medical centers especially after introduction of the magnifying medical
instruments and machines like the microscope and the endoscope.
Main outcome measures: Success was defined as the resolving of the patient symptoms, unobstructed lacrimal
system with irrigation and endoscopic visualization of a patent newostium.
A total of 32 consecutive microscopic and endoscopic endonasal dacryocysto rhinostomy (DCR) procedures
performed between January 2006 and May 2007 were reviewed. In five cases combined nasal procedures was
required. Four patients (12.5%) needed septoplasty operation and one patient (3%) needed removal of a rhinolith.
The success rate was 81.3%, there were 15.6% functional failures and one patient (3%) needed revision surgery
due to recurrent granulation tissue formation at the new ostium region.
The follow-up period ranged from three months to two years. The procedure achieved 81.3 % success rate, in
terms of symptom relief and anatomical success.
The described technique of endonasal dacryocystorhinostomy had a success rate comparable to that of external
dacryocystorhinostomy. The ease of the operation and the smooth postoperative period with good results (over
80% successful rate), indicated that this surgery is taking a wider place in the management of the nasolacrimal
diseases especially stenosis and dacryocele, and accepted more and more by the ophthalmologists, ENT surgeons
and the patients as well