Iraqi Postgraduate Medical Journal

Abstract

ABSTRACT:
BACKGROUND:
Dacryocystorhinostomy (dcr) is the standard trcatmert for nasolacrimal duct Obstruction .based on opening the lacrimal sac, which is connected to the nose, by removing the bone and the mucosa between these two structures at the level of the middle meatus.
OBJECTIVE:
To highlight the procedure of endonasal endoscopic dacryocystorhinostomy.
PATIENTS AND METHODS:
This was a prospective study conducted at Ghazy Al- hariri teaching hospital for surgical specialties during the period from 22nd of February 2011to the 4th of March 2013. A total of 22 patients were referred from the ophthalmologist for endoscopic dacryocystorhinostomy after had been diagnosed as distal obstruction of nasolacrimal duct or sac. Data were collected and all patients were investigated with general pre-operative investigation in addition to CT scanning to exclude any associated abnormalities or neoplasm and rigid nasal endoscopy were performed for all patients. Intranasal decongestant and steroids along with oral antibiotic were given pre-operatively in 14 patients. Endoscopic dacryocystorhinostomy was performed; the patients were followed up for 6 months and evaluated regularly for any complication.
RESULTS:
The mean age of the patients was (32.9 ± 12.7) years with range of (12– 69) years. About 59% of the patients aged 21-40 years. Females were predominant with a female to male ratio of 3.4:1. All patients had mucopurulant conjunctival discharge. The median duration of presentation was 5-6 months. The DCR performed eleven in right side and eleven in left side, and 4 associated operation were conducted for management of associated abnormalities. Eight complications developed during different time of follow up and only one patient needed re insertion giving a success rate of 95.5%.
CONCLUSION:
The endoscopic endonasal DCR is a safe procedure for the treatment of nasolacrimal duct obstruction and with high success rate and less serious complications.