Revision Dacryocystorhinostomy: A Comparison of Endoscopic and External Techniques

Author： Tsirbas Angelo Davis Garry Wormald Peter J.

ISSN： 1539-6290

Source： American Journal of Rhinology, Vol.19, Iss.3, 2005-05, pp. : 322-325

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Abstract

Background: Success rates for revision dacryocystorhinostomy (DCR) are lower than primary DCR. Scarring of the sac may limit the ability of the surgeon to achieve good nasal and lacrimal mucosa apposition. This study evaluates the comparative success rates of the external and endoscopic techniques for revision DCR.Methods: Seventeen consecutive revision endoscopic DCRs (average age, 60.9 years) and 13 revision external DCRs (average age, 65.1years) performed from January 1999 to December 2000 performed by separate surgeons were entered into the study. Patients with functional nasolacrimal and canalicular obstruction were excluded. The average follow-up was 11.1 months for the endoscopic DCR group and 10 months for the external DCR group.Results: A successful DCR required complete relief of symptoms and an endoscopically determined anatomic patency of the nasolacrimal system. Revision endoscopic DCR surgery was successful in 76.5% of cases (13 of 17 cases) and external DCR surgery was successful in 84.6% (11 of 13 cases). This difference was not statistically significant. (p = 0.64, Fisher exact test with a two-tailed probability).Conclusion: Revision endoscopic DCR has a success rate of 76.5%, which compares favorably with that of the revision external DCR (84.6%).