The Relation between Nasal Cavity Size and Success Rate in Endonasal Dacryocystorhinostomy

ABSTRACT

We studied whether the structure and size of nasal cavity around osteotomy site had an influence on the success rate of endoscopic endonasal dacryocystorhinostomy [DCR]. Endoscopic endonasal DCR was performed on 80 eyes of 72 patients who had obstruction of nasolacrimal system.We graded nasal cavity around osteotomy site according to the diameter of drill which could pass[grade I7 mmdrill can pass, grade II5 mmdrill can pass, grade III3 mmdrill can pass, grade IV3 mmdrill cannot pass].The primary success rate is 70%[56 eyes] and final success rate is 81.3%[65 eyes]after secondary operation was perfomed on 14 eyes of 24 failed eyes in primary operation.Primary success rate was 78.8%[41/52 eyes]and 53.6%[15/28 eyes]in grade I-II and grade III-IV, respectively.Final success rate was 86.5%[45/52 eyes]and 71.4%[20/28 eyes]in grade I-II and grade III-IV, respectively.The difference of success rates according to nasal cavity size is stastically significant[P<0.05] and the relation of nasal septum deviation to small nasal cavity is stastically significant[P<0.05].We found canalicular obstruciton in 5 of 14 eyes during secondary operation which was not found in primary speration, and it was suspected to have been caused by mechanical trauma to canalicular system during operation.