Background Endoscopic dacryocystorhinostomy (EDCR) is a minimally invasive surgery used in the treatment of nasolacrimal duct obstruction and chronic dacryocystitis. It involves fistulization of the lacrimal sac into the nasal cavity. Objective The aim was to compare the efficacy and safety of endoscopic dacryocystorhinostomy (En-DCR) with Silicone and polypropylene stents for treatment of primary nasolacrimal ductal obstructions with and without using of MMC. Patients and methods a prospective randomized clinical study involved forty patients with epiphora due to of primary acquired nasolacrimal duct obstruction (PANLDO) attending to the outpatient clinic of departments of Otorhinolaryngology and Ophthalmology of Benha University Hospitals at the period from January 2017 to December 2019. Patients were allocated into two groups. Group (1) Includes 20 patients treated by dacryocystorhinostomy (DCR) with Silicone stent. Group (2) Includes 20 patients treated by dacryocystorhinostomy (DCR) with polypropylene (Prolene) stent. Each group subdivided into two subgroups each of 10 patients (A: used MMC intraoperatively and B: without use of MMC). Ophthalmology and otolaryngology clinics evaluated the patients preoperatively with endoscopes, lacrimal system syringing and dacryocystography. The success of the stents was evaluated after surgery with symptom relief and ostial patency. Results The overall success rate of the En-DCR (as regard to symptom relief and observed duct patency) was 95% and 80% in silicone and prolene groups, respectively. The efficacy of the procedures was slightly increased with use of MMC. Prolene was found to be related with higher incidence of complications. Conclusion The results of our study suggest that efficacy, defined as anatomic and functional success, is higher for silicone than Prolene stents. Also the intraoperative use of MMC is safe and improves the success rate of En-DCR |
