Many types of EnDCR approaches have been tried, yet the long term success rates have not been
equivalent to that achieved with ExDCR. In order to improve the surgical success of EnDCR, there has been
increasing interest in modinfing the way of handling lacrimal sac wall and nasal mucosa. Our prospective study
on 31 patients (7 males and 24 females with age range of 19-52 years) complained of epiphora for at least 1 year
were collected from March 2003 to July 2006 They were diagnosed to have primary nasolacrimal duct
obstruction with no previous :animal surgery. Surgery was pc, formed by the first author. The follow up time
was 6 months during which endoscopic evaluation of DCR and symptoms assessment were evaluated.
The technique we describe encompasses important differences to previously described methods. In involves
creation of a large rhinostomy and creation of a large posterior lacrimal sac flap and a small posterior nasal flap.
This new technique promotes marsupialisation of the lacrimal sac onto the lateral nasal wall due to the close
apposition of the large posterior lacrimal sac flap and small posterior nasal mucosal flap. Major complication
was not found in any case.
Success was defined as endoscopic patency of rhinostome with free flow of fluorescein and fluid during lacrimal
syringing
Our new technique described has a success rate of 87% (27/31) which compares favorably with ExDCR and also
has a greater success rate than conventional endonasal DCR. Our technique does not require the acquisition of
new surgical skills by surgeons or the usage of any sophisticated instruments. This new technique should be
taken in consideration during EnDCR. |
