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Abstract

Objective
To assess and compare the functional and anatomical outcome of endoscopic endonasal dacryocystorhinostomy (EE-DCR) with and without silicone tube placement.
Study desig
Retrospective cohort study.
Place & Duration of study
Department of Ophthalmology, Dr. Ziauddin Hospital Kemari Karachi, from January 2019 to December 2023.
Methods
This study included 204 patients between the ages 18-70 years. Patients with dacryocystitis were divided into two groups. Group A included those in whom EE-DCR was performed with the silicone tube placement and Group B patients who underwent the same procedure but without silicone tube. The outcome of surgery was assessed both objectively (anatomical) and subjectively (functional). The objective outcome was assessed by measuring the size of ostium and patency of nasolacrimal duct by performing probing and syringing on every follow-up visits. The subjective outcome was assessed on the basis of modified Likert score of epiphora.
The data were entered into SPSS version 23 for analysis. Quantitative variables, such as age, were presented as mean ± standard deviation, while qualitative variables, like gender, were presented as frequency and percentages. Chi square test was used for comparison. A p-value < 0.05 was considered as significant.
Results
This study included 204 patients diagnosed with dacryocystitis. They were divided into two groups of 102 each, based upon the surgical approach. In group A, 85 (83.3%) patients and in group B, 96 (94.1%) had a successful objective outcome at follow up which was significant (p=0.01). The subjective outcome assessment showed that in group A, 82 (80.4%) patients had a successful outcome while in group B, 96 (94.1%) had similar results. This was significant (p=0.003). In group A, the ostium size was adequate in 85 (83.3%) patients, while 9 (8.9%) had stenosed ostium. In group B, the ostium size was adequate in 96 (94.12%) patients, while 4 (3.92%) were stenosed.
Conclusion
The comparative analysis showed that EE-DCR without silicone tube placement resulted in less complication rate with quicker recovery time.
Key words
Endonasal endoscopic DCR, Chronic dacryocystitis, Nasolacrimal duct obstruction, Chronic epiphora.