Prospective Comparison of Conventional External Dacryocystorhinostomy and Endonasal Laser Dacryocystorhinostomy
Abstract:
Background: Epiphora, a common manifestation of chronic
dacryocystitis, requires definitive treatment through
dacryocystorhinostomy (DCR), a surgical procedure aimed
at creating an alternative fluid drainage pathway.This study
aimed to assess how effective both external
dacryocystorhinostomy (Ex-DCR) and endonasal
dacryocystorhinostomy (Endo-DCR) are in managing
chronic dacryocystitis, with a specific focus on surgical
duration, complication rates, and treatment outcomes.
Materials & Method: In this study, sixty participants were
prospectively enrolled and evenly divided into two groups.
Thirty patients were assigned to the first group and underwent
En-DCR surgery, while the second group, also comprising
thirty patients, underwent Ex-DCR surgery. Both groups were
monitored for a duration of 9 months and assessed for
surgical duration, perioperative and postoperative
complications, and eventual surgical outcomes.
Results: The distribution of patients across age groups and
sexes was similar between the two groups (p>0.05). Clinical
features such as epiphora, epiphora with discharge, and
epiphora with swelling were comparable between groups.
En-DCR group demonstrated significantly less intraoperative
bleeding (mean:13.5 ml vs 50 ml; p<0.0001) and shorter
operative durations (mean: 20 mins vs 37.5 mins; p<0.0001)
compared to Ex-DCR group. Complications such as nasal
bleeding and hematoma were minimal in both groups, with
no significant differences noted. The final outcome,
categorized as success (En-DCR vs Ex-DCR: 76.7% vs 83.3%)
or failure (23.3% vs 16.7%), did not show a statistically
significant difference between the two groups (p>0.05).
Conclusion: Both surgical techniques offer feasible
alternatives for addressing issues related to nasolacrimal
obstruction.