Endoscopic dacryocystorhinostomy for recurrent epiphora after previous nasolacrimal duct surgery

Mostafa Talaat, Department of Otorhinolaryngology, Minia University, El-Minia 61519, EgyptFollow
Balegh H. Abdelhak, Department of Otorhinolaryngology, Minia University, El-Minia 61519, Egypt
Ayman Samir Megahed, Department of Otorhinolaryngology, Cairo University, Egypt
Mohamed Esmail Khalil, Department of Ophthalmology, Minia University, El-Minia 61519, Egypt
Raafat Abdelrahman Abdallah, Department of Ophthalmology, Minia University, El-Minia 61519, Egypt
Ahmed Abdel Rahman Abdelaziz, Department of Otorhinolaryngology, Minia University, El-Minia 61519, Egypt

Article Type

Original Study

Subject Area

Endoscopic sinus surgery

Abstract

Background: Revision of external DCR may be required due to various factors, including complications of the initial surgery or unaddressed concurrent nasal pathologies. This study focuses on endonasal revision DCR for patients with persistent epiphora symptoms after failed external DCR. Methods: We included 67 patients (19 male and 48 female), aged 19–45, who had previously undergone primary external DCR and presented with persistent epiphora symptoms after at least 12 months of the primary procedure. All patients were clinically examined for concurrent nasal pathology by exploratory endoscopy and computerized tomography (CT) of the nose and paranasal sinuses. Revision endonasal DCR was carried out while concomitantly correcting any underlying nasal pathology. Results: Examination of patients revealed nasal septal deviations in all patients, hypertrophied turbinates in 48 patients, complete nasal obstruction in 25, dacryocystitis in 23, and narrow ostium in 16 patients, besides other lower frequency conditions. All underlying pathologies were corrected surgically in the same surgical setting. Success was achieved in 60 (89.6%) patients. Failure in 7 patients (10.4%) Conclusion: The results of this study highlight the significance of comprehensive preoperative assessment and anatomical evaluation for both primary and revision DCR procedures. Treating epiphora with endonasal endoscopic DCR while correcting the associated nasal pathologies would enhance the success rate.

Keywords

Dacryocystorhinostomy, endoscopy, epiphora, Lacrimal Abscess, Dacryocystitis

Recommended Citation

Talaat M, Abdelhak BH, Megahed AS, et al. Endoscopic dacryocystorhinostomy for recurrent epiphora after previous nasolacrimal duct surgery. Pan Arab J. Rhinol. 2023; 13 : 114-123.
Available at: https://pajr.researchcommons.org/journal/vol13/iss2/7 DOI: https://doi.org/10.58595/2090-7559.1227