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Management of Chronic Dacryocystitis: Comparative Study of Laser and Endoscopic Dacryocystorhinostomy

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Document Type : Research Paper

Abstract

ABSTRACT:
BACKGROUND: 
Dacryocystorhinostomy: a surgical procedure to bypass the lacrimal sac and duct to create new path of tear into nose to treat epiphora (tearing due to reduced transport of tear  or  defective drainage of tear  outflow caused by  obstruction  of nasolacrimal duct).
OBJECTIVE:
Our study’s aim was to compare the surgical outcomes between endoscopic DCR and endocanalicular diode laser DCR including pre operative circumstances, type of anesthesia, intraoperative duration and amounts of bleeding, post operative pain and complications, success rates after 9 months of follow up.
PATIENTS AND METHODS:
60 patients  were operated; 30 of them as endoscopic DCR group A (28 of them in Al Shaheed Ghazi Al Hariri Teaching Hospital and other 2 in Al Mukhtar Hospital) and 30 as Endocanalicular diode laser DCR group B in Ibn Al-Haithem Teaching Hospital in period  between June 2017 to June 2018. All patients were assessed by detailed history and examination included fluoresceine dye, probing, irrigation of Lacrimal system and nasal examination.
RESULTS:
60 patients, mean age was 36.43 ± 17.405 years(5-79 years), 16 males and 44 females, 31 left eyes and 29 right eyes ,the chronicity of  symptoms ranged from 6 months to 14 years, CT scans were done for 24 patients (22 in group A and2 in group B). The mean duration of operation was 38.13± 9.51 minutes in group A, 32.63±11.02 in group B. The mean intraoperative bleeding was 68.93±29.49 ml in group A, 56.33±21.57 ml in group B. There is no significant difference in pain and complications in both groups. The success rate in group A was 96.67% while in group B was 63.33%.  The results were comparable to other studies.
CONCLUSION:
Both our groups have the advantages of: absence of facial scar, short duration especially in Endocanalicular diode DCR, less bleeding and pain, lacrimal pump preservation with successful rate comparable to the external DCR especially in endoscopic DCR.
 
 

Keywords

References

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Iraqi Postgraduate Medical Journal
Volume 22, Issue 2
April 2023
Page 197-206
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