Abstract
BackgroundTo evaluate the clinical outcome of primary endonasal laser assisted dacryocystorhinostomy (ENL-DCR) using the potassium-titanyl-phosphate laser.MethodsWe retrospectively reviewed all primary ENL-DCRs performed within a period of twelve months by the same combined Ophthalmology and Otorhinolaringology team in Freeman Hospital, Newcastle upon Tyne, UK. The main outcome measure for success was resolution or significant improvement of epiphora. Details of surgery, intraoperative and postoperative complications, as well as pathology associated with failure were also studied. Patients were followed up for at least 12 months.ResultsA total of 41 consecutive ENL-DCRs on 29 patients (22 females, 7 males, mean age 75 years) were analysed. All patients had bicanalicular silicone intubation for at least 4 months. The success rate at 12 months postoperatively was 78.1%. Pathology associated with failure included: intranasal pathology (12.2%), mucocele (7.3%), and systemic sarcoidosis (2.4%). No significant intra-operative complications were recorded.ConclusionThe ENL-DCR with potassium-titanyl-phosphate laser can be considered as a safe and efficient primary procedure for the treatment of nasolacrimal duct obstruction.
Highlights
To evaluate the clinical outcome of primary endonasal laser assisted dacryocystorhinostomy (ENL-DCR) using the potassium-titanyl-phosphate laser
We evaluate the clinical outcome of 41 consecutive primary ENL-DCRs that were performed on 29 patients using the KTP laser over a period of one year
Forty- seven consecutive primary ENL-DCR operations with lacrimal intubation were performed from March 2001 to February 2002 on 35 patients with primary acquired nasolacrimal duct obstruction
Summary
To evaluate the clinical outcome of primary endonasal laser assisted dacryocystorhinostomy (ENL-DCR) using the potassium-titanyl-phosphate laser. Dacryocystorhinostomy (DCR) is the treatment of choice for patients with chronic stenosis and obstruction of the nasolacrimal duct. External dacryocystorhinostomy (EXTDCR) was first described by Toti [1,2] in 1904. The endonasal approach was first introduced in 1893 by Caldwell [3,4], but it was inherently limited by poor visibility of endonasal anatomy during surgery. The introduction of high-resolution fiberoptic endoscopes in the late 1980s enabled adequate visualisation of the nasal cavities, and permitted minimally invasive surgery, under local anaesthesia, avoiding visible facial scarring[5,6]. Endonasal dacryocystorhinostomy (ENL-DCR) can be performed either entirely surgically[7] or with the assistance of laser to create the fistula. Massaro, Gonnering and Haris [8,9] were the first to describe the endonasal (page number not for citation purposes)
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