The role of Accompanying Sinonasal Abnormalities in the Outcome of Endonasal Dacryocystorhinostomy

Abstract

Acquired nasolacrimal duct obstruction may occur simultaneously and possibly as a consequence of sinonasal disease, because the nasolacrimal system is anatomically related to important nasal and sinus structures. Thirty-seven patients with nasolacrimal canal obstruction (42 eyes) were evaluated with paranasal sinus computerized tomography (CT) to determine the presence of sinonasal abnormalities if any. All of the patients underwent endoscopic dacryocystorhinostomy (end-DCR) and accompanying sinonasal pathology was treated also in the same session. Paranasal sinus CT examinations revealed one or more sinonasal abnormalities in 26 (73.3%) patients. The postoperative success rate of end-DCR procedure in patients with sinonasal abnormalities was 82.8%, whereas this figure increased to 92.3% in patients without additional sinonasal disease. However, additional rhinological surgery did not affect the success rate of end-DCR procedure significantly (p = 0.640). These data establish a positive correlation between sinonasal abnormalities and the presence of nasolacrimal outflow obstruction, but the additional rhinological surgery does not significantly affect the results of the end-DCR procedure.