Rahul Telang1, Mehak Maheshwary2, Samir Joshi3
Tearing and recurrent or chronic conjunctival discharges are the most frequent symptoms of lacrimal pathway obstruction. Endoscopic endonasal dacryocystorhinostomy (DCR) surgery with mucosal flap technique used in our study involves creation of a large rhinostomy and mucosal flaps with use of diamond burr attached to a powered microdebrider. With creation of a well healed marsupialised ostium, the lacrimal sac is made a part of lateral nasal wall. MATERIALS AND METHODS: The study involved a prospective non-randomized interventional case series of 50 patients operated with endoscopic endonasal DCR with mucosal flap technique with use of powered instruments. Data based on the symptomatic relief, nasal endoscopy and syringing after the management were recorded after duration of one week, one month and six months for each patient. OBSERVATIONS AND RESULTS: Success rate at 6 months considering the anatomical patency and operative site was 96% i.e. 48/50 patients showed desirable outcome of the procedure. Also the success rate in terms of symptomatic relief after 6 months was 96% i.e. 48/50 patients showed complete resolution of epiphora after 6 months. CONCLUSION: Our study concluded that this technique involves creation of a large rhinostomy and the preservation of lacrimal sac and nasal mucosa leads to marsupialization of lacrimal sac onto the lateral nasal wall. The extensive drilling of frontonasal process of maxilla helps in creation of a stable opening of about 1cm x 1cm. No post-operative nasal packing given or stent was used, hence minimal discomfort to the patient
