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Analysis of 104 Cases of Endonasal Dacryocystorhinostomy in a Tertiary Care Hospital: A Prospective Study
Authors:Rashmi Goyal  Saroj Gupta
Institution:1. Department of ENT, Peoples College of Medical Sciences & RC, Bhanpur, Bhopal, 462037, India
2. Department of Ophthalmology, Peoples College of Medical Sciences & RC, Bhanpur, Bhopal, 462037, India
Abstract:To evaluate the results of endoscopic endonasal dacryocystorhinostomy performed in a tertiary care hospital. Prospective, nonrandomized, interventional clinical study. A prospective interventional study was performed on 104 patients presenting with epiphora between January 2006 and January 2010. All patients were operated by one surgeon. Out of 104 cases, 08 cases were of revision endonasal dacryocystorhinostomy (DCR). Bicanalicular silicon intubation was performed in all cases of revision endonasal DCR. Twelve patients had concomitant sinonasal disease for which septoplasty or FESS was done. The patency of nasolacrimal duct was assessed by doing syringing of lacrimal passage weekly for 1 month, monthly for 3 month, then at 6 month and 1 year. Out of 104 patients 10 patients lost follow up after surgery. Ninety four patients were followed for 1 year. On syringing, rhinostomy site was found patent in 80 patients (85.10 %), therefore they were fully satisfied. In 6 cases (6.38 %) minimal block was seen with clear fluid regurgitation, were to some extent symptomatically relieved and were found to be satisfied, whereas in 08 cases (8.51 %) syringing showed complete block. They required further management. Success rate of our study is comparable to other studies on endonasal DCR as well as external DCR, with advantages of less intra-operative bleeding, shorter operative time, better cosmesis, preservation of lacrimal pump mechanism. Other nasal pathology can be treated at the same time. Our results are clinically as well as statistically highly significant (P value < 0.0001).
Keywords:Endonasal dacryocystorhinostomy  Epiphora  Nasolacrimal duct obstruction  Silicon intubation
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