Results of endoscopic endonasal dacryocystorhinostomy: a prospective cohort study

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Objective: To evaluate the success rate of endoscopic endonasal Dacryocystorhinostomy

Methods: This prospective cohort study was conducted at Ophthalmology and Otorhinolaryngology Department of Shifa Foundation Community Health Centre, Islamabad, Pakistan, from Oct 2017 to Sep 2019. The patients with chronic dacryocystitis who underwent endoscopic endonasal Dacryocystorhinostomy (DCR) were enrolled. Data for demographic information and clinical features (mucocele, deviated nasal septum, epiphora, purulent discharge and regurgitation test, history of acute dacryocystitis and probing and syringing etc.) was noted. Endoscopic DCR with or without lacrimal intubation was performed under general anesthesia. Patients were reviewed at post-operative week1, 1 month, 6 months and 12 months with documentation of epiphora, purulent discharge, need for syringing, nasal adhesions etc. Telephonic interviews were done in cases of missing data. Statistical analysis was done with SPSS 20.0.

Results: The study enrolled 47 patients, majority of them were females (87.2%).  The mean age of patients was 40.70 ± SD 10.84 yrs, Range 25-66 yrs.. Minimum postoperative follow up period was 12 months; mean duration (14.53 ± 3.0 months). Lacrimal intubation was performed in 31 (66%) patients. Nasal endoscopy was performed and lacrimal tubes were removed after 6 months post operatively. Surgical success was achieved in 46 (97.9%) patients: 37 (78.7 %) patients were completely symptom free, 9 (19.1%) were partially symptomatic and were managed conservatively. Treatment failure requiring repeat surgical procedure was observed in only one patient (2.1%).