Outcomes of Endoscopic Endonasal Dacryocystorhinostomy with Nasal and Lacrimal Flaps Preservations
Authors/Creators
- 1. MBCHB. Fellow of the Arab Board, CABS, Fellow of the European (FEB) (ORAL-HNS), Instructor at Ibn Sina University of Medical and Pharmaceutical Science. Baghdad Iraq.
- 2. MBCHB, Fellow of the Arab Board, CABS (ORL-HNS), Instructor at Jabber Bin Haiyan University of Medical and Pharmaceutical Science. Najaf- Iraq.
- 3. 3. MBCHB. Fellow of the Arab Board, CABS (ENT-HNS), Fellowship of Iraqi Board ENT (FICMS), Najaf Teaching Hospital, Najaf- Iraq.
- 4. 4. MD- CAB, DLO, FICMS (ORL-HNS) Consultant, AL Sadder Teaching Hospital, Najaf- Iraq
Description
ABSTRACT
Background: Endoscopic Endonasal Dacryocystorhinostomy (DCR) is common surgical procedure in the treatment of chronic dacryocystitis to overcome the distal naso-lacrimal system obstruction; nonetheless, after surgery, stenosis, and failure are common. Despite the satisfactory results obtained with the traditional external approach, the disadvantage of this method is the need for skin incision that cause consequent scar.
Objective: To assess the outcomes of Endonasal Endoscopy Dacryocystorhinostomy with preservation of nasal and lacrimal mucosa
Patients and methods: This was a clinical trial conducted in Najaf at Al-Sader Medical City, Iraq, during the period from October 2019 to 2021. Endoscopic endonasal DCR was performed which involved creating nasal mucosal and large posterior lacrimal flaps, at the medial wall of the lacrimal sac with close apposition of the two flaps.
Results: Septoplasty was performed in (14.2%) of cases at the time of operation to get access to lacrimal sac area. In 8.5 percent of cases, conchoplasty from the middle turbinate was also added to this method. Revision surgery was done in 5 (14.2%) cases. In 7 patients stents were placed on. Symptomatic and anatomical success was reported in 94.2%. The success rate using this method was comparable to that of an external technique & it could be better than other endoscopic techniques.
Conclusion: Mucosal flap preservation is probably more important innovation in endoscopic DCR surgery what makes it convenient for the surgeon, and for the patient, as well as we reported a 94.2% success rate, the procedure was simple , affordable and comparable to external DCR and better than other endoscopic techniques.