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Abstract ID: 24-172
Endoscopic Dacryocystorhinostomy (En-DCR), How to increase the success rate and long term results, A new approach
Abolfazl RAHIMI
Purpose
Endoscopic dacryocystorhinostomy is an established surgery for the nasolacrimal duct obstruction. Large and smooth area of opening of Lateral wall of the sac without any bare bone is ideal for endoscopic DCR. In this study, we aim to show the results and a new technique how to improve the nasal side opening and also the function of tear pump.
Methods
Case series, showing a technique how to operate and use nasal flap and lacrimal sac wall for reconstruction of the new opening of the lacrimal drainage system.
Results
Eighty-six patients with proved Nasolacrimal Duct Obstruction underwent the Endoscopic DCR with our technique. Seventy-seven patients (90%) had Primary Acquired Nasolacrimal Duct Obstruction and the rest (10%) were secondary to previous sinonasal surgeries. All the 86 patients (100%) had epiphora as the main complaint. Seven patients had abscess and one patient had fistulae. Fifty-nine patients were Female (69%). The patient age range was 8 to 73 years old. Nine patients had additional septoplasty during their operation. The patients were followed 13 to 24 months. The Objective and subjective success rates were 99% and 97%, respectively. The technique, how to reconstruct the nasal side of lacrimal system, how to save normal function of tear pump and medial canthus and the short and long term results will be shown. The Objective and subjective success rates were 99% and 97%.
Conclusion
Endoscopic DCR has been established as an effective operation with acceptable results during the last decade. Regarding the lacrimal drainage anatomy, it is logical to choose this operation as the first choice, but low success rate, steep learning curve and the cost of equipments have been made it difficult to be the first operation option. Avoiding the bare bones completely, saving the normal anatomy and tear pump function as much as possible and how to reconstruct the nasal side of the lacrimal system are the key points to high objective and more important subjective success rates. In this study, we believe our technique will increase the success rate of this operation addressing all of previous mentioned key points.
Additional Authors
S Hadi Samimi – Farhikhtegan Hospital, Department of Ophthalmology, Tehran Medical Sciences, Islamic Azad University, Tehran, IRAN
Farhad Adhami Moghaddam – Farhikhtegan Hospital, Department of Ophthalmology, Tehran Medical Sciences, Islamic Azad University, Tehran, IRAN