Endonasal Dacryocystorhinostomy: Results With or Without Stenting.

Introduction This is a comparative cross-sectional study done to compare the curative outcome of endonasal dacryocystorhinostomy (DCR) done with and without a silicon stent in patients with chronic dacryocystitis due to nasolacrimal duct obstruction. Methods This study was carried out in central India, involving 60 patients who were diagnosed with chronic dacryocystitis and underwent endonasal DCR (with zero-degree and 45-degree endoscopes from Olympus, with an Olympus camera and monitor) between October 2021 and September 2022. All patients were over the age of 18, with major exclusion criteria of previous DCR and sinonasal disease. All the surgeries were done by the same senior surgeon, in which 30 patients were stented (with a Prison silicone nasolacrimal duct stent) and 30 of them were non-stented. The follow-up duration for these was 12 months after the surgery.  Results The outcome was evaluated at the end of three months, six months, and 12 months for both groups (patients with and without stents) using the Chi-square test. The success rate at the end of six months was 90% with stented patients and 93.3% with non-stented patients (p-value - 0.64); at six months, it was also the same (p-value - 0.64); and at the end of 12 months, it was 80% and 76.6% (p-value - 0.71) for patients with and without a stent, respectively. The final endoscopy at the end of 12 months showed 93.3% of patients who underwent stenting had a patent rhinostomy opening, and 90% of those who were not stented had a patent opening. Conclusions Our observational comparative study showed that patients with chronic dacryocystitis who underwent endonasal DCR with and without stenting had almost similar results. There was no significant difference in the outcome. So, we concluded that generally all the patients should be considered for endonasal DCR without a stent, except in special cases like revision endonasal DCR, lacrimal gland cysts, fistulas, and patients with sinonasal pathology, in whom silicon stents can be preferred.