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 modifying 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 March2000 to July 2003.They were
diagnosed to have primary nasolacrimal duct obstruction with no previous lacrimal
surgery. Surgery was performed 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. It involves creation of a large rhinostomy and creation of a large
posterior lacrimal sac flap and a small posterior nasal mucosa! 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 considerable during EnDCR. |
