Endoscopic Management of Nasolacrimal Duct Obstruction

Abstract

The endonasal dacryocystorhinostomy approach has been shown to be a relatively safe, reliable option in the management of distal lacrimal passage obstruction either bilateral, unilateral or recurrent cases. Once the need for DCR is established, the E •.. DCR offers more advantages over external DCR for the technical surgery. The endonasal dacryocystorhinostomy (E.DCR) approach not only avoids an external facial scar but also preserves the functional pump mechanism of tearing by maintaining the integrity of the orbicularis oculi muscle and medial palpebral ligament. The E.DCR approach allows for correction of any intranasal pathological condition that may have contribute to DCR failure. In this study, the success rate for E.DCR was 92% with two • procedures, primary one, 90 % and revision surgery increased to 92 %, with follow up about 18 months ,The endonasal DCR allow rapid return to normal function. Although preoperative computerized tomography scanning (CT) is not commonly used in-patients with nasolacrimal duct obstruction (NLD) who undergo DCR It is best to obtain routine CT scans in all patients presenting with NLD obstruction. CT scanning •help to detect the level of obstruction and any underlying anatomical variants.