Clinical Outcome of Dacryocystorhinostomy with Septal Deviation

Abstract

Purpose: Septal deviation has few subjective symptoms. However, a difficulty remains in doing DCR (dacryocystorhinostomy) in these patients. We investigate the clinical course of DCR in patients with a septal deviation. Methods: Acquired nasolacrimal duct-obstructed patients who had undergone DCR with septal deviation from 2003 to 2006 in our hospital were retrospectively analyzed. We measured the septal distance using paranasal computed tomography taken preoperatively and compared the sex and age of patients, the kinds of operations, outcome of surgery, and ocular and nasal complications in our analysis. Results: Twenty-two eyes of 22 patients with a mean age of 55.3 years (range 29～74) were analyzed (4 males, 18 females). Mean septal distance was 4.84 mm (range 2.18～6.99 mm). Nineteen eyes had endonasal DCR, and three had external DCR. Two had DCR combined with septoplasty. Three had septoplasty as a secondary operation, Nasal complication was synechiae in 9 eyes. DCR success was seen in 15 eyes, and DCR failure in 7 eyes. Septal distance was not correlated with DCR success but was correlated with nasal complication (Mann-Whitney test, p=0.003) Conclusions: In the case of DCR with septal deviation, the surgical technique used will need to minimize the mucosal injury and ensure appropriate nasal correction to prevent future complications.