Meta-Analysis of Flaps Management in External Dacryocystorhinostomy

Abstract

Background: Dacryocystorhinostomy (DCR) describes the creation of a functional pathway from the canaliculi into the nose through creating an osteotomy and opening the nasolacrimal sac into the nose. It can be performed via an external or endonasal approach. External dacryocystorhinostomy (DCR) is the gold standard treatment of epiphora caused by acquired nasolacrimal duct obstruction due to patient acceptance, low cost, and high success rate. DCR aims to form a new, mucosa-lined pathway between the lacrimal sac and the nasal cavity where tears can bypass a lacrimal obstruction and drain directly in the nose. The original external approach was described in 1904.In the 1920s, mucosal flap anastomosis was added to the procedure as a modification, and since then, many new modifications have been made to improve the original procedure. Objectives: To evaluate the outcomes of external DCR by using two different patterns of flap anastomosis; one only with anterior flap anastomosis and the other with both anterior and posterior flap anastomosis. Materials and Methods: We followed the PRISMA statement guidelines 44during this systematic review and meta- analysis preparation. All steps were performed according to the Cochrane handbook of systematic reviews of intervention.