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EndoscopicDacryocystorhinostomyEndoscopicDacryocystorhinostomyProf Sajid Mirza

Dr Khalid MahidaDr Mohammad Ayub

Dr QurratulAin Paracha

Prof Sajid Mirza

Dr Khalid MahidaDr Mohammad Ayub

Dr QurratulAin Paracha

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is a commonly performed operation in

which a fistulous tract is created between

the lacrimal sac and the nasal cavity in

order to relieve the epiphora due to

nasolacrimal duct obstruction

Endoscopic DCR

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IndicationsIndications Epiphora caused byanatomicor

functional lacrimal sacornasolacrimal duct

obstruction Chronic dacryocystitis with purulentdrainage fromthe canaliculi

Inflammationofthe skinoverlyingthelacrimal sacinthe regionofthe medialcanthus

Dacryolith formation Benignlacrimal sacmass

Epiphora caused byanatomicorfunctional lacrimal sacornasolacrimal duct

obstruction Chronic dacryocystitis with purulentdrainage fromthe canaliculi

Inflammationofthe skinoverlyingthelacrimal sacinthe regionofthe medialcanthus

Dacryolith formation Benignlacrimal sacmass

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ADVANTAG

ES,A

DVANTAG

ES, Itprovidesa betteraestheticresultwithno

external scar.

Itallowsaone-stage procedure toalsocorrectassociatednasal pathologythatmaybe causative.

Itavoidsinjurytothe medial canthus and/orpathologicscar formation.

Itprovidesa betteraestheticresultwithnoexternal scar.

Itallowsaone-stage procedure toalsocorrectassociatednasal pathologythatmaybe causative.

Itavoidsinjurytothe medial canthus and/orpathologicscar formation.

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Itpreservesthe pumpingmechanismofthe orbicularis oculi muscle.

Active infectionofthe lacrimal systemisnotacontraindicationtosurgery.

Itis especiallysuperiortothe externalapproachinrevisionsurgery

Itpreservesthe pumpingmechanismofthe orbicularis oculi muscle.

Active infectionofthe lacrimal systemisnotacontraindicationtosurgery.

Itis especiallysuperiortothe externalapproachinrevisionsurgery

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Itismuch less bloodyandmessythanthe external approach.

The perioperative time isshorter.

The successrate iscomparable totheexternal approach.

Itismuch less bloodyandmessythanthe external approach.

The perioperative time isshorter.

The successrate iscomparable totheexternal approach.

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DisadvantagesDisadvantages Itrequires specialized training in nasal

endoscopic surgery.

The endoscopic equipment is anexpense.

Itrequires specialized training in nasalendoscopic surgery.

The endoscopic equipment is anexpense.

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Complications-IntraoperativeComplications-Intraoperative

Epistaxis.

Orbital fat may be exposed.

Damage to the medial rectus andsuperior oblique may cause diplopia.

Epistaxis.

Orbital fat may be exposed.

Damage to the medial rectus andsuperior oblique may cause diplopia.

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Postoperative complicationsPostoperative complications

Epistaxis

Infection in the nose or orbit

Adhesions

Pyogenicgranulomata may occur at thepuncta or the site of rhinostomy

Persistentwatering may indicate scarring ofthe rhinostoma and may require reoperation.

Epistaxis

Infection in the nose or orbit

Adhesions

Pyogenicgranulomata may occur at thepuncta or the site of rhinostomy

Persistentwatering may indicate scarring ofthe rhinostoma and may require reoperation.

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Preop. workup

Preop. workup

Opthalmological examination

ENT examination

HematologyBiochemistry

Dacryocystgraphy

Opthalmological examination

ENT examination

HematologyBiochemistry

Dacryocystgraphy

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DemographyDemography Male 08

Female 17

Total no. 25

Male 08

Female 17

Total no. 25

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Age group

Age group

15-30 = 09

30-45 = 09

45-60 = 07

15-30 = 09

30-45 = 09

45-60 = 07

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Unilateral 24 (R-17, L-08)

Bilateral 01

Prevoius failedsurgery 10

Revision 01

Unilateral 24 (R-17, L-08)

Bilateral 01

Prevoius failedsurgery 10

Revision 01

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Concomitant

Nasal

Pathology

Concomitant

Nasal

Pathology

Deviated nasal Septum 5 Deviated nasal Septum 5

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Result

Result

Improvement of symptoms

At2nd and 4th weeknosymptoms 16

NoimprovementAt4 week 01

Improvement of symptoms

At2nd and 4th weeknosymptoms 16

NoimprovementAt4 week 01

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