Comparative Study of Endonasal Endoscopic Dacryocystorhinostomy with or without Preservation of Nasal Mucosal Flap.

OBJECTIVE

To analyse the result of endoscopic endonasal dacryocystrhinostomy with or without preservation of nasal mucosal flap.

STUDY DESIGN

Randomised prospective cohort design.

SETTING

Tertiary academic centre.

SUBJECTS AND METHODS

100 patients who presented with epiphora and diagnosed as chronic dacryocystitis after syringing by ophthalmologist, were selected and randomised into two groups. Standard surgical procedure of endoscopic endonasal dacryocystorhinostomy was carried out except for the preservation of flap in group A and without preservation of flap in group B. Additional surgeries were done according to necessity. Postoperatively, patients were followed up on OPD-basis at the end of 1week, 2 week, 1month, and 3 month. Symptomatic improvement was assessed and patency checked by syringing by the ophthalmologist.

RESULTS

Nil intraoperative complications (p < 0.05) and nil postoperative complication noted (p < 0.05). Functional and anatomical patency found to be 100% at the end of 1 week in both groups, 96% at 3 month in case group A and 98%, 92% and 82% respectively at the end of 2 week, 1 month and 3 month in group B. Nasal endoscopy of all surgical failures showed restenosis in both groups and synechiae in 2 patients in group B.

CONCLUSIONS

Preservation of nasal mucosal flap with modification around stoma can be used to cover the bared bone with avoidance of granulation tissue formation reducing the risk of closure of ostium with large rhinostomy and improve success of endoscopic endonasal DCR.