Background: Dacryocystorhinostomy (DCR) is a surgical procedure by which the lacrimal flow is diverted into the nasal cavity by making an artificial opening at the level of the lacrimal sac. It is indicated when there is symptomatic obstruction of the nasolacrimal duct (NLD), which is not relieved by simple probing and syringing. Poor lacrimal drainage can be due to mechanical obstruction or lacrimal pump failure. In 1989, Mc Donogh and Meiring described the endoscopic transnasal DCR. It is the gold standard treatment for NLD obstruction causing epiphora.
Materials and methods: This is a prospective study, and the sample size is 36. Patients who underwent endoscopic endonasal DCR between September 2020 and April 2022 were included in the study. This includes 20 DCRs with stents and 16 DCRs without stents. Stents used in this study were urology (urethral) stents and infant feeding tube no. 10. Patients aged between 18 and 70 years were included.
Results: The success rate at the end of 6 months follow-up for nonstent was 81.21% and with stent was 95% (p = 0.005), and among the stents, urology stents had a success of 100% and infant feeding tube no.10 had a success rate of 90% (p = 0.004). Females were more affected than males.
Conclusion: In this study, easily available and cost-effective stent in comparison with DCR stents like infant feeding tubes and urology stents were used for stenting and stenting had upper edge on comparison with nonstenting. Our study suggests that postoperative cases with stents reduce the chances of granulation and synechiae.
Shashidhar K, Nagalotimath U, Dixit D. Endoscopic dacryocystorhinostomy with and without silicone stenting: A comparative study. Al Ameen J Med Sci 2014;7(3):244−247. DOI: 10.18535/jmscr/v4i9.91.
Wasl H, Lubbe D. Endoscopic dacryocystorhinostomy (DCR) surgical technique [Internet]. Open access atlas of otolaryngology head and neck operative surgery. 2018. Available from: https://vula.uct.ac.za/access/content/group/ba5fb1bd-be95-48e5-81be-586fbaeba29d/Endoscopic%20dacryocystorhinostomy%20_DCR_%20surgical%20technique.pdf.
Mohamad SH, Khan I, Shakeel M, et al. Long-term results of endonasal dacryocystorhinostomy with and without stenting. Ann R Coll Surg Engl 2013;95(3):196−199. DOI: 10.1308/003588413X13511609957939.
Linberg JV, McCormick SA. Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique. Ophthalmology 1986;93:1055–1063. DOI: 10.1016/s0161-6420(86)33620-0.
Shah CK, Bhalodiya NH. Endonasal dacryocystorhinostomy: A comparative study between conventional mucosal flap and silicone stenting. Clin Rhinol 2018;11(1):15–17. DOI: 10.5005/jp-journals-10013-1335.
Orsolini MJ, Schellini SA, Meneguim RLS, et al. Success of endoscopic dacryocystorhinostomy with or without stents: Systematic review and meta-analysis. Orbit 2020;39(4):258–265. DOI: 10.1080/01676830.2019.1677726.
Bharangar S, Singh N, Lal V. Endoscopic endonasal dacryocystorhinostomy: Best surgical management for DCR. Indian J Otolaryngol Head Neck Surg 2012;64(4):366–369. DOI: 10.1007/s12070-011-0345-0.
Shams PN, Wormald PJ, Selva D. Anatomical landmarks of the lateral nasal wall: Implications for endonasal lacrimal surgery. Curr Opin Ophthalmol 2015;26(5):408–415. DOI: 10.1097/ICU.0000000000000160.