Abstract

Purpose: An external dacryocystorhinostomy (Ex-DCR) is a surgical procedure wherein a fistula is created between the lacrimal sac and nasal mucosa. Although the conventional approach to an Ex-DCR procedure is time-consuming and may result in complications, it is considered the gold-standard technique for the management of nasolacrimal duct obstruction (NLDO). This study aimed to evaluate the outcomes of a modified Ex-DCR approach with intubation and in which both the anterior lacrimal sac and nasal mucosal flaps were excised while the posterior flap was left hanging free.

Methods: A retrospective chart review study, included all consecutive adult patients with primary NLDO who underwent modified Ex-DCR procedures. Data were collected from electronic patient records, including oculoplastic and orbital surgical notes. All patients underwent a minimum of 12 months of follow-up. Success was defined according to lacrimal patency and symptomatic relief.

Results: A total of 45 patients underwent modified Ex-DCR procedures with intubation and excision of both the anterior lacrimal sac and nasal mucosal flaps. During the 12-month follow-up period, 43 (95.6%) demonstrated a patent lacrimal drainage system and were symptom-free. Two patients (4.4%) developed secondary obstruction with persistent epiphora.

Conclusion: The excision of both the anterior lacrimal sac and nasal mucosal flaps during a modified Ex-DCR procedure resulted in a high success rate comparable to that reported in the international literature with standard techniques. In addition, this procedure might shorten the surgical time required. However, further studies are required to determine if such modifications hold a statistical advantage over conventional techniques.

Keywords: External Dacryocystorhinostomy; Nasolacrimal Duct Obstruction; Epiphora; Lacrimal Sac; Nasal Mucosa

References

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Citation

Citation: Abdullah S Al-Mujaini., et al. “Outcome of External Dacryocystorhinostomy with Excision of Both the Anterior Lacrimal Sac and Nasal Mucosal Flaps and Preservation of the Posterior Flaps". Acta Scientific Paediatrics 3.10 (2020): 28-32.

Copyright

Copyright: © 2020 Abdullah S Al-Mujaini., et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.