Endonasal microscopic surgery of the lacrimal duct stenosis – long-term results

Introduction
The value of a complex endonasal microsurgical treatment of lacrimal duct stenosis.

Material and methods
In a group of 418 patients we performed 455 dacryocystorhinostomy (DCR) including 37 bilaterally. They were 263 females (62.9%) and 155 males (37.1%). Age ranged from 1.5 to 87, mean age 54.3 years. Performance: general anaesthesia with controlled hypothension, semi sitting position of patient and adjustable headrest, operating microscope (300 mm lens). Operative procedure: septum mobilization and anterior ethmoidectomy, dacryocystorhinostomy (DCR).

Results
Satisfactory results were obtained in 436 of cases (95.8%), 19 no change (4.2%). Only 18 cases received a prosthesis. There were only 2 complications (0.2) not serious.

Conclusions
Endonasal microscopic dacryocystorhinostomy preserves intact bony support and frame of lacrimal ducts and the nasal function of the lacrimal pump. It allows simultaneous management of the concomitant sino-nasal pathology as well as shorter operation times, lower complication rates and reduced patient morbidity.