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Adam H. Dao, Anika G. Bradley, James Dickson; Otolaryngology-Assisted Endoscopic Dacryocystorhinostomy Has High Success Rate. Invest. Ophthalmol. Vis. Sci. 2012;53(14):1031.
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To determine the success rate of endoscopic dacrycystorhinostomy by an oculoplastic surgeon with the assistance of an otolaryngologist.
A retrospective chart-review was performed of all patients undergoing dacrycystorhinostomy from October 2007 to December 2010 by one oculoplastic surgeon with the aid of the same otolaryngologist. Complete resolution or marked symptomatic improvement of epiphora from baseline by history noted on a follow-up appointment was considered a success.
From October 2007 to December 2011 in one oculoplastics clinic in South Carolina, 64 patients diagnosed with nasolacrimal duct obstruction underwent 79 dacryocystorhinostomies by an oculoplastic surgeon who was aided by an otolaryngologist for endoscopic nasal mucosal elevation and nasal bone removal. On follow-up assessment, 73 out of 75 eyes (97.3%) and 59 out of 60 (98.3%) patients had no epiphora and were symptomatically improved (follow-up time 2 months to 2.75 years). One patient was excluded as the endoscopic dacryocystorhinostomy procedure was converted intraoperatively to an external approach. Three additional patients were symptomatically improved but were excluded because they were lost to follow-up beyond the first post-operative appointment.
Otolaryngology-assisted endoscopic dacryocystorhinostomy performed by an oculoplastic surgeon yielded excellent outcomes which exceeded current published data. This chart review suggests success rates approaching that of the gold standard, external dacryocystorhinostomy. A recent study pooled literature outcomes of endoscopic dacryocystorhinostomy and found a success rate of 82.4% and another found a success rate of external dacryocystorhinostomy between 80-99%. If validated with further, prospective studies, otolaryngology-assisted endoscopic dacryocystorhinostomy may become the standard of care for surgical management of nasolacrimal duct obstruction.
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