Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation

Nickisa Hodgson, Emily Bratton, Katherine Whipple, Ayelet Priel, Sang Rog Oh, Robert G. Fante, Don O. Kikkawa, Bobby S. Korn

Research output: Contribution to journalArticle

Abstract

PURPOSE: Dacryocystorhinostomy (DCR) is the standard procedure for the treatment of acquired nasolacrimal duct obstruction (NLDO) that can be performed through an external or endonasal approach. Both techniques create a fistula from the lacrimal sac into the nasal cavity via a bony osteotomy. Historically, external DCR has been considered the gold standard; however, recent reports suggest endonasal DCR is an effective alternative. There are numerous variations of endonasal DCR described in the literature that report variable success rates. The purpose of this study is to describe the approach and success rate with endonasal DCR in which nasal mucosa, bone, and lacrimal sac mucosa are sequentially removed. METHODS: The authors retrospectively reviewed cases of endonasal DCR from 2004 to 2011 from 2 institutions (the University of California, San Diego, California, and the Fante Eye and Face Center in Denver, Colorado, U.S.A.). Patients with a history of epiphora and NLDO confirmed with punctal irrigation were included. Exclusion criteria were the presence of canalicular obstruction, history of orbital trauma, and prior DCR surgery. Success was defined as subjective relief of epiphora and confirmation of ostium patency with irrigation. RESULTS: A total of 324 patients (74 men, 250 women; mean age 59.3) encompassing 407 endonasal DCR cases were included in the study. The total case success rate was 92.2% with an average follow-up time of 91.5 days. Revision surgery was performed in 7 of the failed cases and resulted in success in 6 of these cases. CONCLUSIONS: Endonasal DCR is a simple and effective approach to surgically treat NLDO and offers success rates comparable with external DCR.

Original languageEnglish (US)
Pages (from-to)24-27
Number of pages4
JournalOphthalmic Plastic and Reconstructive Surgery
Volume30
Issue number1
DOIs
StatePublished - Jan 1 2014
Externally publishedYes

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Dacryocystorhinostomy
Nasolacrimal Duct
Lacrimal Apparatus Diseases
Nasal Bone
Nasal Mucosa
Nasal Cavity
Osteotomy
Reoperation
Fistula
Mucous Membrane

ASJC Scopus subject areas

  • Surgery
  • Ophthalmology

Cite this

Hodgson, N., Bratton, E., Whipple, K., Priel, A., Oh, S. R., Fante, R. G., ... Korn, B. S. (2014). Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation. Ophthalmic Plastic and Reconstructive Surgery, 30(1), 24-27. https://doi.org/10.1097/IOP.0b013e3182a7502e

Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation. / Hodgson, Nickisa; Bratton, Emily; Whipple, Katherine; Priel, Ayelet; Oh, Sang Rog; Fante, Robert G.; Kikkawa, Don O.; Korn, Bobby S.

In: Ophthalmic Plastic and Reconstructive Surgery, Vol. 30, No. 1, 01.01.2014, p. 24-27.

Research output: Contribution to journalArticle

Hodgson, N, Bratton, E, Whipple, K, Priel, A, Oh, SR, Fante, RG, Kikkawa, DO & Korn, BS 2014, 'Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation', Ophthalmic Plastic and Reconstructive Surgery, vol. 30, no. 1, pp. 24-27. https://doi.org/10.1097/IOP.0b013e3182a7502e
Hodgson, Nickisa ; Bratton, Emily ; Whipple, Katherine ; Priel, Ayelet ; Oh, Sang Rog ; Fante, Robert G. ; Kikkawa, Don O. ; Korn, Bobby S. / Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation. In: Ophthalmic Plastic and Reconstructive Surgery. 2014 ; Vol. 30, No. 1. pp. 24-27.
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