Surgical Results of Modified Dacryocystorhinostomy

PURPOSE: To evaluate the surgical results of endoscopic modified dacryocystorhinostomy (DCR). METHODS: The authors operated on patients with upper punctal and canalicular obstruction associated with nasolacrimal duct obstruction and performed endoscopic modified DCR. One end of a lacrimal tube was passed into the nasal cavity through an excision site of the caruncle and internal ostium and the other end of the tube was inserted into the nasal cavity through a patent punctum and the newly created intranasal ostium. The two ends were tied together in the nasal cavity in modified DCR. RESULTS: The primary success rate of modified DCR was 71.0%. Of the four failed cases, one underwent CDCR using Jones tube. CONCLUSIONS: The author's modified DCR may be a suitable alternative method to CDCR or DCR using monocanalicular silicone tube to relieve epiphora in patients with NLD obstruction associated with upper punctal and canalicular obstruction.

Clinical Evaluation of Endoscopic Endonasal Conjunctivodacryocystorhinostomy (CDCR) with Jones Tube Placement

PURPOSE: To evaluate the efficacy of endoscopic endonasal primary conjunctivodacryocysto-rhinostomy (CDCR) and revision CDCR after primary CDCR. METHODS: Twenty patients who had undergone endoscopic endonasal CDCR with Jones tube and who were followed for over 6 months at our hospital were reviewed retrospectively. Our analysis included success rate, operation time and causes of failure. RESULTS: The indications for revision CDCR were prolapse of Jones tube and inadequate tube length. The initial success rate in the primary and revision groups was 78.6% (11/14) and 100% (6/6), respectively. Two initial failures in the primary group were later successful after revision. The mean operation time in the groups was 23.9 minutes ( +/- 6.3) and 21.7 minutes ( +/- 6.1), respectively. The main causes of failure included inaccurate tube length and abnormal tube position. CONCLUSIONS: Endoscopic endonasal CDCR appears to be a reasonable approach for revision, as well as primary, because of accurate measurement of Jones tube length during surgery and the shortened operation time.

Comparison of Surgical Results between Endoscopic and Conventional Conjunctivodacryocystorhinostomy

Conventional Conjunctivodacryocystorhinostomy[CDCR]which is performed for canalicular obstruction or failed DCR, is well known as one of the most effective treatment modalities. The authors compared surgical results of endoscopic with those of conventional method to evaluate advantages of endoscopic method over conventional CDCR and important success factors. Primary success rates were 90%[86/96]in endoscopic method and 86%[214/217]in conventional method. Final success rates were 97%[93/96]and 96%[237/247]in endoscopic and conventional method, respectively[p>0.05]. We considered that endoscopic method was superior to conventional method in accurate measurement of Jones tube length at the time of endoscopic operation. It was considered the most important success factor.