Abstract ID: 26-235
Comparison of endoscopic and external dacryocystorhinostomy for treatment of primary acquired nasolacrimal duct obstruction.
Author: Amal Minocha Base Hospital / Institution: Barking, Havering And Redbridge University Hospitals NHS Trust
Presentation Type: ePoster Presentation
Purpose
To compare symptomatic and anatomical outcomes of endonasal versus external dacryocystorhinostomy (DCR) for primary nasolacrimal duct obstruction (NLDO) over five years, and to evaluate re-intervention rates.
Methods
A retrospective audit of 158 patients undergoing endonasal or external DCR for primary NLDO in a district general hospital was performed. Canalicular obstruction and secondary causes were excluded. Symptomatic outcomes were classified as complete resolution of epiphora (Group 1), partial improvement but still has epiphora (Group 2), or failure /no improvement to epiphora (Group 3). Anatomical success was assessed where documented. Based on syringing post intervention. Re-interventions and time to failure were analysed.
Results
158 procedures were performed of which 96 were endonasal DCR and 62 external DCR. The mean age of patient was 57 for endonasal and 63 years for external with average ASA grade being 1.9 and 2.1 respectively. Overall symptomatic improvement among the entire cohort was 92% (68% complete, 24% partial), with 8% failures.
67.4% of endonasal DCR procedures achieve complete resolution (Group 1), 24.2% partial resolution (Group 2) and 8.4% failure (Group 3) compared with 67.7% of external DCR in group 1, 24.2% in group 2 and 8.1% in group 3 with no significant difference (p=0.998).
Anatomical patency was observed in 94% of endonasal and 95% of external DCR. The most common reason for failure in both groups was scarring at the ostium. Re-intervention was performed in 15 patients (7 (7.3%) endonasal and 8 (12.9%) external) with the mean time to failure for endonasal and external DCR being 162 and 157 days respectively.
Conclusion
Both endonasal and external DCR demonstrate similarly high symptomatic success rates in primary NLDO. The distribution of complete resolution, partial improvement, and failure were comparable between the two surgical techniques, with no statistically significant difference though re-intervention rates were higher in external DCR. The choice of technique performed should therefore be based on patient preference, surgical experience and nasal anatomy.
Additional Authors
| First name | Last name | Base Hospital / Institution |
|---|---|---|
| Adele | Mazzoleni | Barking, Havering And Redbridge University Hospitals NHS Trust |
| Anna | Gkountelia | Barking, Havering And Redbridge University Hospitals NHS Trust |
| Marta | Garcia-Vilaro | Barking, Havering And Redbridge University Hospitals NHS Trust |