External Dacryocystorhinostomy Versus Endonasal Dacryocystorhinostomy for Chronic Dacryocystitis: A Prospective Comparative Study
Journal Title: Ophthalmology and Allied Sciences - Year 2018, Vol 4, Issue 3
Abstract
Introduction: Dacryocystorhinostomy (DCR) is an operation that creates a fistula between the lacrimal sac and nasal cavity to facilitate drainage of the tears in cases of nasolacrimal duct obstruction. Initially ‘DCR’ was performed by using an external approach for acquired nasolacrimal duct obstruction. Of lately endoscopic DCR is evolving as an equally effective alternative intervention. Objective: The present study is to correlate the surgical outcome of external DCR and endonasal DCR regarding the patency rate and to assess the intraoperative and postoperative complications of both the interventions. Materials and Method: This prospective clinical study was carried out in the Department of Ophthalmology and ENT, SIMS and RC, Bangalore, from 2016-2017. A total of 30 consecutive patients having complaints of watering with complete nasolacrimal duct obstruction diagnosed by syringing; known cases were selected for DCR surgery. Dacryocystography was done in all the cases. Among 30 patients a total of 15 patients underwent external DCR and rest of the patients underwent endoscopic DCR. Revision cases were excluded from the study group. A detailed history, regarding symptoms was collected systematically. Data pertaining ocular examination, lacrimal syringing, intra-operative and postoperative complications and finally ultimate surgical outcome were collected. Data was analyzed by SPSS statistical software. ROC test was employed to draw the significant inference. Results: The result showed that both surgical approaches had almost similar success rate ie. external DCR had 87% success rate with good specificity of 89.0% and sensitivity 79.99% and endoscopic DCR had 80% success rate with 83.22% specificity and sensitivity 71.88%. The complication rate was low in both the groups and no appreciable difference in complication rate was seen in both types of surgery p> 0.01. Conclusion: Surgical outcome of both endoscopic and external DCR for Chronic Dacryocystitis was quite satisfactory p<0.001. The complication rate was low. Thus, these two different dacryocystorhinostomy techniques will be acceptable alternatives for the treatment of chronic dacryocystitis. With external DCR still the gold standard for chronic dacryocystitis, endoscopic DCR is a safe, minimally invasive effective alternative to external DCR, but it requires expertise and expensive equipment for endoscopy.
Authors and Affiliations
Ashwini K. V.
Keywords
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- EP ID EP551308
- DOI 10.21088/oas.2454.7816.4318.6
- Views 99
- Downloads 0
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