Long-term outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation

Todd T. Kingdom, Henry P. Barham, Vikram D. Durairaj

Research output: Contribution to journalReview article

Abstract

Objective: A growing body of evidence demonstrates that endonasal endoscopic dacryocystorhinostomy (eDCR) techniques provide comparable results to conventional external techniques. The purpose of this study was to evaluate long-term outcomes after powered endoscopic DCR without preservation of mucosal flaps for the management of acquired nasolacrimal duct obstruction performed by a single surgical team. Methods: A retrospective review was performed of patients with epiphora secondary to acquired nasolacrimal duct obstruction who underwent eDCR without mucosal flap preservation from May 2003 to April 2013 at a tertiary referral medical center. Main outcome measures were subjective improvement in epiphora and assessment of anatomic patency based on lacrimal irrigation and endoscopic evaluation. Results: Eighty patients (69 primary and 11 revision) totaling 103 procedures (87 primary, 16 revision) were available for analysis at a mean follow-up of 28.7 (range 6–114) months. At the most recent follow-up, 92 of 103 (89.3%) procedures had complete resolution of epiphora, and 10 of 103 procedures achieved mild intermittent epiphora. Complete resolution of epiphora was noted in 93.1% (81 of 87) of primary procedures and 68.8% (11 of 16) of revision procedures. Objective anatomic patency was confirmed in 98% (101 of 103). A revision procedure was required in 5.8% (6 of 103). Conclusion: Outcomes of powered eDCR without the preservation of mucosal flaps compare favorably to previously reported results in the literature. These long-term results suggest that mucosal flap preservation is not required to achieve successful outcomes with eDCR. Level of Evidence: 4 Laryngoscope, 130:12–17, 2020.

Original languageEnglish (US)
Pages (from-to)12-17
Number of pages6
JournalLaryngoscope
Volume130
Issue number1
DOIs
StatePublished - Jan 1 2020

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Dacryocystorhinostomy
Lacrimal Apparatus Diseases
Nasolacrimal Duct
Laryngoscopes
Tears
Tertiary Care Centers
Outcome Assessment (Health Care)

Keywords

  • Epiphora
  • dacryocystorhinostomy
  • nasolacrimal duct obstruction

ASJC Scopus subject areas

  • Otorhinolaryngology

Cite this

Long-term outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation. / Kingdom, Todd T.; Barham, Henry P.; Durairaj, Vikram D.

In: Laryngoscope, Vol. 130, No. 1, 01.01.2020, p. 12-17.

Research output: Contribution to journalReview article

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abstract = "Objective: A growing body of evidence demonstrates that endonasal endoscopic dacryocystorhinostomy (eDCR) techniques provide comparable results to conventional external techniques. The purpose of this study was to evaluate long-term outcomes after powered endoscopic DCR without preservation of mucosal flaps for the management of acquired nasolacrimal duct obstruction performed by a single surgical team. Methods: A retrospective review was performed of patients with epiphora secondary to acquired nasolacrimal duct obstruction who underwent eDCR without mucosal flap preservation from May 2003 to April 2013 at a tertiary referral medical center. Main outcome measures were subjective improvement in epiphora and assessment of anatomic patency based on lacrimal irrigation and endoscopic evaluation. Results: Eighty patients (69 primary and 11 revision) totaling 103 procedures (87 primary, 16 revision) were available for analysis at a mean follow-up of 28.7 (range 6–114) months. At the most recent follow-up, 92 of 103 (89.3{\%}) procedures had complete resolution of epiphora, and 10 of 103 procedures achieved mild intermittent epiphora. Complete resolution of epiphora was noted in 93.1{\%} (81 of 87) of primary procedures and 68.8{\%} (11 of 16) of revision procedures. Objective anatomic patency was confirmed in 98{\%} (101 of 103). A revision procedure was required in 5.8{\%} (6 of 103). Conclusion: Outcomes of powered eDCR without the preservation of mucosal flaps compare favorably to previously reported results in the literature. These long-term results suggest that mucosal flap preservation is not required to achieve successful outcomes with eDCR. Level of Evidence: 4 Laryngoscope, 130:12–17, 2020.",
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AB - Objective: A growing body of evidence demonstrates that endonasal endoscopic dacryocystorhinostomy (eDCR) techniques provide comparable results to conventional external techniques. The purpose of this study was to evaluate long-term outcomes after powered endoscopic DCR without preservation of mucosal flaps for the management of acquired nasolacrimal duct obstruction performed by a single surgical team. Methods: A retrospective review was performed of patients with epiphora secondary to acquired nasolacrimal duct obstruction who underwent eDCR without mucosal flap preservation from May 2003 to April 2013 at a tertiary referral medical center. Main outcome measures were subjective improvement in epiphora and assessment of anatomic patency based on lacrimal irrigation and endoscopic evaluation. Results: Eighty patients (69 primary and 11 revision) totaling 103 procedures (87 primary, 16 revision) were available for analysis at a mean follow-up of 28.7 (range 6–114) months. At the most recent follow-up, 92 of 103 (89.3%) procedures had complete resolution of epiphora, and 10 of 103 procedures achieved mild intermittent epiphora. Complete resolution of epiphora was noted in 93.1% (81 of 87) of primary procedures and 68.8% (11 of 16) of revision procedures. Objective anatomic patency was confirmed in 98% (101 of 103). A revision procedure was required in 5.8% (6 of 103). Conclusion: Outcomes of powered eDCR without the preservation of mucosal flaps compare favorably to previously reported results in the literature. These long-term results suggest that mucosal flap preservation is not required to achieve successful outcomes with eDCR. Level of Evidence: 4 Laryngoscope, 130:12–17, 2020.

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