Endoscopic Endonasal Dacryocystorhinostomy Combined with Canaliculus Repair for the Management of Dacryocystitis with Canalicular Obstruction

Abstract EN

Purpose.

The aim of this study is to propose a simple and efficient combination surgery for the management of dacryocystitis with canalicular obstruction.

Methods.

A retrospective noncomparative case series of dacryocystitis with canalicular obstruction has been studied.

Twelve patients with dacryocystitis and canalicular obstruction underwent a conventional endoscopic endonasal dacryocystorhinostomy (EE-DCR) combined with a modified canalicular repair.

Postoperative observations included slit lamp, fluorescein dye disappearance test, lacrimal syringing, lacrimal endoscopy, and nasal endoscopy.

Results.

After 6–18 months of postoperative follow-up, the symptoms of epiphora and mucopurulent discharge disappeared completely in 10 patients, and occasional or intermittent epiphora remained in 2 patients.

All of the twelve patients showed an opened intranasal ostium and normal fluorescein dye disappearance test.

Patent bicanalicular irrigation was achieved in 9 patients.

One patient had a partial and the other two had a complete reobstruction by lacrimal irrigation to their repaired lower canaliculus; however, all of them had a patent lacrimal irrigation to upper canaliculus.

The functional success rate for the combination surgery is 83% (10/12), and anatomical success rate is 75% (9/12).

Conclusion.

EE-DCR combined with modified canalicular repair is a simple and efficient method for the management of dacryocystitis with canalicular obstruction.