TO STUDY THE ANATOMICAL VARIATION ENCOUNTERED DURING ENDOSCOPIC DACRYOCYSTORHINOSTOMY
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Keywords
Dacryocystorhinostomy, endoscopic, nasolacrimal, success rate, nasal septum, sac localization.
Abstract
Background: Endoscopic DCR (EnDCR) has emerged as a minimally invasive alternative to external DCR, offering superior visualization and cosmetic outcomes. The present analysis aims to evaluate the anatomical variations encountered during the EnDCR.
Methods: A prospective observational study on 70 participants was conducted to assess the effectiveness and safety of EnDCR. The surgical success rate, intraoperative anatomical variations, and pre-, intra-, and postoperative complications were recorded. Adjunct nasal surgeries were performed as needed to address anatomical obstructions.
Results: EnDCR achieved a high success rate of 97.14% at six weeks postoperatively. Complication rates were low: preoperative (8.57%), intraoperative (31.43%), and postoperative (4.29%). Common anatomical variations included gross deviated nasal septum, concha bullosa, and thick lacrimal bone, necessitating procedures such as septoplasty or partial turbinectomy in selected cases. Surgical success was attributed to accurate sac localization, adequate bone removal, full sac marsupialization, and mucosal apposition. Postoperative nasal irrigation was emphasized to prevent neo-ostium obstruction.
Conclusion: EnDCR is safe, and cosmetically superior approach for managing nasolacrimal duct obstruction. Success is enhanced by addressing anatomical variations, ensuring wide osteotomy and complete sac exposure, and promoting primary intention healing through mucosal alignment and postoperative care.
References
2) Ozer S, Ozer PA. Endoscopic vs external dacryocystorhinostomy-comparison from the patients' aspect. Int J Ophthalmol. 2014;7(4):689 96.
3) Jutley G, Karim R, Joharatnam N, Latif S, Lynch T, Olver JM. Patient satisfaction following endoscopic end on a salda cryocy storhinostomy: a quality of life study. Eye. 2013;27(9):1084-9.
4) Zaidi FH, Symanski S, Olver JM. A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction. Eye (London, England). 2011;25(9):1219-24.
5) Konuk O, Kurtulmusoglu M, Knatova Z, Unal M. Unsuccessful lacrimal surgery: causative factors and results of surgical management in a tertiary referral center. Ophthalmologica. 2010;224:361-6.
6) Argin A, Görür K, Ozcan C, Arslan E, Ozmen C, VayisogluY.The role of larger osteotomy in long term success in external dacryocystorhinostomy. J Plast Reconstr Aesthet Surg. 2008;61(6):615-9.
7) Liang J, Hur K, Merbs SL, Lane AP. Surgical and anatomic considerations in endoscopic revision of failed external dacryocystorhinostomy. Otolaryngol Head Neck Surg. 2014 May;150(5):901-5. doi: 10.1177/0194599814524700. Epub 2014 Mar 4. PMID: 24596236.
8) Tadke K, Lahane V, Sarode A, Nitish. Endonasald acryocystorhinostomy: evaluation of the anatomical and functional results. Int J Otorhinolaryngol Head Neck Surg 2020;6:519-26.
9) Shashidhar K, Nagalotimath U, Dixit D. Endoscopic dacryocystorhinostomy with and without silicone stenting: A comparative study. Al Ameen J Med Sci 2014;1:4 5.
10) Ahmad S, Pant B. Role of silicone stenting in endoscopic dacryocystorhinostomy: A comparative study. Int J AdvIntegr Med Sci 2016;1:4 6.
11) Prinja S, Dhanoa S, Singh G, Kaur K, Gupta S, Bansal G. A comparative study of endoscopic endonasaldacryocystorhinostomy with and without stenting. Acta Med Int 2023;10:96 101.
12) Unlu HH, Gunhan K, Baser EF, Songu M. Long term results in endoscopic dacryocystorhinostomy: Is intubation really required? Otolaryngol Head Neck Surg 2009; 140:589 95.
13) Monga J, Sharma Y, Mishra G, Patel M. Resolving perplexity: Comparison of endoscopic dacryocystorhinostomy with and without stent. Indian J Otolaryngol Head Neck Surg 2019;71:1843 8.
14) Pandey R, Yadav PK, Patel AK, Rani P. Outcome of primary endoscopic dacrocystorhinostomy with and without stent: A randomised prospective study. Int J Otorhinolaryngol Head Neck Surg 2018;4:137 40.
15) Chowdhury K, Haldar A, Pervej MK. Endoscopic DCR with or without stent in a peripheral tertiary care Centre of West Bengal – Our experience. J Evid Based Med Health 2020;7: 2474 8.
16) Maldhure SV, Golhar PS, Moon PP. Endonasaldacryocystorhinostomy: Results with or without stenting. Cureus 2023;15:e33470.
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Dr. Ravi Ganeshkar
Assistant Professor at Department of ENT/Otorhinolaryngology, Dr. PDMMC, Amravati, Maharashtra, India
Dr. Shrikant Mahalle
Assistant Professor at Department of ENT/Otorhinolaryngology, Dr. PDMMC, Amravati, Maharashtra, India
Dr. Anil Patil
Assistant Professor at Department of ENT/Otorhinolaryngology, Dr. PDMMC, Amravati, Maharashtra, India