Evaluating the Results of Endoscopic Dacryocystorhinostomy as Primary Treatment for Acute Dacryocystitis


The results of utilising endoscopic DCR as the main therapy for acute dacryocystitis in adults are highlighted in the current study. 30 patients with nasolacrimal duct block who presented with acute dacryocystitis and accompanying sequelae, including preseptal cellulitis, lacrimal empyema, with or without a spontaneous lacrimal fistula, were the subject of a retrospective case series investigation.

Antibiotics taken orally were begun at the same time. All individuals were taken while being sedated intravenously. The same surgeon performed surgery on each of the chosen patients. The effectiveness was measured by how much the discomfort, edoema, and epiphora had decreased. Following surgery, a follow-up was conducted at 1, 4, and 6 months. Lacrimal syringing was performed to check the sac’s patency at each subsequent visit. Every time, endonasal cleaning was performed on the granulation tissue. The anterior end of the middle turbinate received intranasal infiltration in all planes. The mucosal flap was raised while still preserving hemostasis. Using bony markers such the anterior end of the middle turbinate and the posterior edge of the frontal process of the maxilla, bone over the medial wall of the lacrimal sac was excised. In contrast to other research, which focused on lacrimal empyemas, this study shown that endoscopic DCR may be utilised to treat sequelae of acute dacryocystitis such cellulitis and fistulas. In this trial, no DCR stents were used.

The procedure had a 92.85 percent success rate.

ll procedures went smoothly, and the enlarged sac region made it much simpler to locate the surgical site. Due to the existence of a deviated nasal septum, several of the patients received a concomitant septoplasty procedure. No DCR stents or tubes were utilised throughout the procedure. The edoema and epiphora were lessened on the first post-operative day. All of the patients’ pain subsided as well, however in 4 of the patients, the pain subsided gradually over the course of 2 days. Patent lacrimal channels were seen with lacrimal syringing.

Following treatment, at 1 week and 1 month, the osteotomy was suctioned endonasally clear of all the granulation tissue. At a 6-month checkup, the osteotomy was still intact in 26 individuals.

The combined use of endo-DCR, antibiotics, and anti-inflammatory medications resulted in a 92.5% success rate.

Author (s) Details:

Reshma Pathan,
Department of Ophthalmology, Navodaya Medical College, Raichur, Karnataka, India.

Rizwan Pathan,
Department of ENT, Navodaya Medical College, Raichur, Karnataka, India.

Ayisha Afreen,
Department of Ophthalmology, Navodaya Medical College, Raichur, Karnataka, India.

Please see the link here: https://stm.bookpi.org/CODHR-V1/article/view/7429

Keywords: Endoscopic dacryocystorhinostomy, Epiphora, NLD, granulation tissue, lacrimal sac.

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