Head And Neck Surgery Research Articles

Prevalence of Endolymphatic Hydrops in Cochlear Implant Candidates with Idiopathic Profound Sensorineural Hearing Loss.

To determine the prevalence of endolymphatic hydrops (EH) in cochlear implant (CI) candidates with idiopathic profound sensorineural hearing loss (SNHL) and its influence on the preservation of audiovestibular function after cochlear implantation. Prospective case series. Tertiary referral center. CI candidates with idiopathic progressive SNHL, but without classic EH-associated symptoms. Delayed intravenous gadolinium-enhanced inner ear fluid-attenuated inversion recovery magnetic resonance imaging as well as pure-tone audiograms, video head impulse tests, and vestibular evoked myogenic potentials before and 4 weeks after cochlear implantation. Prevalence of EH before cochlear implantation, audiovestibular function before and after surgery in hydropic and nonhydropic ears. Thirty-two ears in 16 CI candidates were included. Nine ears (28%) with EH were detected. Although preoperative hearing thresholds, utricular function, and semicircular canal function were not different between the two groups, saccular function was reduced in hydropic ears. Ten subjects received a unilateral CI. Of these, 3 (30%) showed EH on the implanted side. There was no difference regarding postoperative hearing loss between the two groups, but the results point toward a higher vulnerability of hydropic ears with respect to loss of otolith function after cochlear implantation. This is the first study showing that EH can be assumed in about one third of CI candidates with idiopathic profound SNHL, but no classic EH-associated symptoms. Preliminary results suggest that EH has no influence on the preservation of cochlear function but could be a risk factor for loss of otolith function after cochlear implantation.

Cost of open access publishing in otolaryngology-head and neck surgery.

Open access (OA) publishing makes research more accessible but is associated with steep article processing charges (APCs). The study objective was to characterize the APCs of OA publishing in otolaryngology-head and neck surgery (OHNS) journals. We conducted a cross-sectional analysis of published policies of 110 OHNS journals collated from three databases. The primary outcomes were the publishing model, APC for original research, and APC waiver policy. We identified 110 OHNS journals (57 fully OA, 47 hybrid, 2 subscription-only, 4 unknown model). After excluding 12 journals (2 subscription-only, 4 unknown model, 5 OA with unspecified APCs, and 1 OA that accepts publications only from society members), we analyzed 98 journals, 23 of which did not charge APCs. Among 75 journals with nonzero APCs, the mean and median APCs were $2452 and $2900 (interquartile range: $1082-3520). Twenty-five journals (33.3%) offered APC subsidies for authors in low- and middle-income countries (LMICs) and/or on a case-by-case basis. Eighty-five and 25 journals were based in high-income countries (HICs) and LMICs, respectively. The mean APC was higher among HIC journals thanLMIC journals ($2606 vs. $958, p < 0.001). APCs range from tens to thousands of dollars with limited waivers for authors in LMICs.

Does the journal impact factor predict individual article citation rate in otolaryngology journals?

Citation skew is a phenomenon that refers to the unequal citation distribution of articles in a journal. The objective of this study was to establish whether citation skew exists in Otolaryngology-Head and Neck Surgery (OHNS) journals and to elucidate whether journal impact factor (JIF) was an accurate indicator of citation rate of individual articles. Journals in the field of OHNS were identified using Journal Citation Reports. After extraction of the number of citations in 2020 for all primary research articles and review articles published in 2018 and 2019, a detailed citation analysis was performed to determine citation distribution. The main outcome of this study was to establish whether citation skew exists within OHNS literature and whether JIF was an accurate prediction of individual article citation rate. Thirty-one OHNS journals were identified. Citation skew was prevalent across OHNS literature with 65% of publications achieving citation rates below the JIF. Furthermore, 48% of publications gathered either zero or one citation. The mean and median citations for review articles, 3.66 and 2, respectively, were higher than the mean and median number of citations for primary research articles, 1 and 2.35, respectively (P < .001). A statistically significant correlation was found between citation rate and JIF (r = 0.394, P = 0.028). The current results demonstrate a citation skew among OHNS journals, which is in keeping with findings from other surgical subspecialties. The majority of publications did not achieve citation rates equal to the JIF. Thus, the JIF should not be used to measure the quality of individual articles. Otolaryngologists should assess the quality of research through the use of other metrics, such as the evaluation of sound scientific methodology, and the relevance of the articles.

Tranexamic acid administration practice in otolaryngology head & neck surgery; international survey

PurposeTranexamic acid (TXA) is a potent pro-coagulation drug. Pre-operative, preventive TXA administration and TXA use for active bleeding are established treatments in many medical situations; yet, less is known about its use in otolaryngology head and neck surgery practice.The primary study goals were:1.Evaluate physician practice, patients profile, and TXA administration indications.2.Characterize practice differences between academic and non-academic physicians and between two countries. Materials and methodsThis is an international survey exploring TXA administration strategy. The electronic, anonymous, questionnaire was emailed to all registered Israeli and American Otolaryngology Head and Neck Surgery (OHNS) physicians, investigating TXA administration:1.Patient age and comorbidities2.Active bleeding indications3.Preventive bleeding indications in common operations in otolaryngology. ResultsOverall, 317 otolaryngologists participated in the study. TXA was administered to 40.5 % of the pediatric population and 50 % of the adult patients when needed. Epistaxis was the most common indication for TXA administration (48–55 %). A small number of otolaryngologists, 4–13 %, recommended preventive TXA for various operations. More surgeons include TXA in their practice and adjusted the dose according to renal function in academic compared to non-academic medical centers and among otolaryngologists practicing in Israel compared to the United States. ConclusionsTXA is provided by many otolaryngologists to treat active epistaxis but to a substantially lesser extent as a preventive measure. TXA is given to children and adults, some with substantial comorbidities. Treatment is more common among surgeons working in academic institutes and medical centers in Israel.

EP-244 A “missed” nasal button battery in a child during the COVID-19 pandemic

A 5-year-old boy was referred acutely to the on-call ENT doctor following multiple remote consultations with his general practitioner with 2 months history of worsening left-sided foul-smelling nasal discharge and bleeding. He underwent examination under anaesthesia and removal of nasal foreign body which was subsequently identified as a button battery (intra-operative as well as imaging pictures included). This case highlights the challenges posed to clinicians during the COVID-19 pandemic but also serves as a reminder to keep a high index of suspicion and low threshold for clinical examination in suspected cases of nasal foreign body. It also highlights that since COVID19 omicron variant has emerged it is more than significant to evaluate cases that are assessed remotely with increased care to avoid any further misses or mistakes.

Postoperative Urinary Retention in Japanese Elderly Males with a Femoral Neck or Trochanteric Fracture.

We assessed risk factors for postoperative urinary retention (UR) in elderly males with femoral bone fractures: 169 Japanese males (mean age 81.95 ± 1.19 years) who had undergone hip surgery at a municipal hospital (Toyama, Japan). A multiple logistic regression analysis was used to test possible risk factors for UR: age, body mass index, serum albumin, cognitive impairment, activities of daily living (ADL), and history of diabetes mellitus (DM). UR occurred in 24 (14.2%) of the 169 patients. A multivariate logistic regression analysis with age adjustment showed that ADL (odds ratio [OR] 3.88; 95% confidence interval [CI]: 1.2-12.5, p=0.023) was significantly associated with the development of UR, and a history of DM showed marginal significance for UR occurrence (OR 0.36, 95%CI: 0.11-10, p=0.064). These results suggests that ADL is a risk factor for UR development in elderly males who have undergone surgery for femoral neck or trochanter fractures.

Pattern of Malignancy in Thyroid Swelling

Background: Incidence of thyroid malignancy is increasing day by day in thyroid swelling. The exact cause of cancer is not known. But there are few predisposing factors in genesis of thyroid malignancy such as age, sex, geographical distribution, familial predisposition, radiation exposure, pre-existing thyroid disease. Papillary thyroid carcinoma is most common among all thyroid malignancy with high incidence of lymph node metastasis. The aim of this study is to find out the pattern of malignancy in thyroid swelling.&#x0D; Methods: This cross-sectional observational study was done in department of Otolaryngology- Head neck surgery; Dhaka Medical College Hospital for 6 months. 50 Patients with thyroid swelling undergone operative management were included.&#x0D; Results: Results of this study showed that the highest numbers of patients were in 31-40 years of age group numbering 20 (40%). There were 42 females comprising 84% and males comprising 8 (16%) with female to male ratio 5.25:1. Among the thyroid swelling 35 (70%) cases were solid &amp; 15 (30%) cases were cystic and 38 cases were non-neoplastic and 12 cases were neoplastic. Among the 12 cases 7 cases were malignant. Papillary carcinoma was predominant having 6 (85.7%) cases and Follicular carcinoma was in 1 (14.28%) case and out of 7 cases metastatic cervical lymph node was in 1 (14.28%) case which was from papillary carcinoma.&#x0D; Conclusion: Incidence of thyroid malignancy in thyroid swellings is high. Male patients with thyroid swelling has more chance of thyroid malignancy and papillary thyroid carcinoma is the commonest of all thyroid malignancy with cervical neck node metastasis.&#x0D; Bangladesh J Otorhinolaryngol 2022; 28(1): 78-83

Clinical Presentation of Thyroglossal Cysts and Sinuses

Objective: To see the clinical presentation of thyroglossal cysts and sinuses.&#x0D; Methods: Observational type of Cross sectional study. Department of ENT &amp; Head-Neck Surgery in Sher-E-Bangla Medical College Hospital, Barishal from September 2014 to February 2015. All patients attended in the Department of ENT and Head Neck Surgery in Sher-E-Bangla Medical College Hospital, Serum TSH, USG of thyroid swelling and FNAC were done for diagnoses and for evaluation.&#x0D; Results: Thyroglossal cysts and sinuses were found in 23(63.9%) and 13(36.1%) cases respectively. The mean age of presentation was found 16.6±11.3 years in cysts group and 15.5±7.2 years in sinus group. Regarding the site of cysts 4(17.4%) cases was suprahyoid, 11(47.8%) infrahyoid and 8(34.8%) at the level of hyoid. Regarding the site of sinus 1(7.7%) case was suprahyoid, 9(69.2%) infrahyoid and 3(23.1%) at the level of hyoid. All the patients had normal thyroid gland in both group, all of them had normal serum TSH level. FNAC was done in all cyst patients and shows normal cystic lesion with no malignancy. But in sinus patients only one FNAC was done and reported as cystic lesion.&#x0D; Conclusion: Thyroglossal cysts and sinuses were more common in 2nd decade and male predominant. Majority of the cysts are Infrahyoid and on the right side of midline and majority of sinuses are Infrahyoid and on the right side. Development of sinuses is due to operation following abscess formation in majority of cases.&#x0D; Bangladesh J Otorhinolaryngol 2022; 28(1): 7-15

Clinicopathological Study of Sinonasal Malignancy-Experience in a Tertiary Level Hospital in Bangladesh

Objectives: To assess the clinical presentation and histopathological types and extensions of the disease at the time of presentation.&#x0D; Methods: Cross sectional observational study of 40 patients with sinonasal malignancy from the department of otolaryngology and Head neck surgery, Sylhet MAG Osmani Medical College Hospital, Sylhet Bangladesh, period from May 2019 to April 2020. The patients were examined after admission into hospital pre-operatively and in the postoperative period. The surgical specimens were sent for Histopathology.&#x0D; Results: Majority patients were at 4th to 6th decade where male outnumbered the female with male female ratio was 3.4:1. Out of 40 patients, the majority of patients complaints of nasal obstruction followed by nasal discharge, facial pain, facial swelling and headache. About the site of the lesion maximum patients having the lesion in Maxillary sinus (60%) followed by nasal cavity (15%) multiple sinuses (12.5%) involvement in Ethmoidal sinus (10%) lateral wall of nose (2.5%)&#x0D; Conclusion: Sinonasal Malignancy is usually a disease of middle age and elderly people. Most of the patients (in this study 65% patients come at T3 &amp; T4 stage) presented late with multiple symptoms.&#x0D; Bangladesh J Otorhinolaryngol 2022; 28(1): 37-42

Early and Late Complications after Thyroid Surgery: A Retrospective Study in 163 Patients

Objective: The aim of this study was to evaluate the early and late (6 months after surgery) complications in patients undergoing thyroid surgery.&#x0D; Material &amp; methods: A retrospective study was done from January 2015 to December 2019 in the Department of ENT &amp; Head Neck Surgery, Enam Medical College &amp; Hospital. One hundred and sixty three patients with both benign &amp; malignant thyroid disease underwent surgical treatment was selected for this study. Patients were followed up for six months and peroperative &amp; postoperative complications were evaluated.&#x0D; Results: Out of 163 patients 132(80.9%) cases were benign and 31(19.1%) cases were malignant. Total thyroidectomy was done in 71(43.56%) patients and hemithyroidectomy was done in 82(50.3%) patients and 10(6.13%) patients had other thyroid surgery. 29(17.80%) patients develop complications after thyroid surgery. Most common post operative complication was hypoparathyroidism with a incidence of 17(10.43%). 15(9.20%) patients developed temporary hypocalcaemia and 2(1.23%) patients developed permanent hypocalcaemia. Others complications were recurrent laryngeal nerve (RLN) palsy 2(1.23%), superior laryngeal nerve (SLN) palsy 3(1.84%), wound infection 2(1.23%), haematoma 1(0.61%) and hypertrophied scar 4(2.45%).&#x0D; Conclusion: Hypocalcaemia was the most frequent post-thyroidectomy complication, while voice change, seroma, haematoma, wound infection and hypertrophied scar are additional complications. Surgeons have to pay attention to curtail the complications during thyroid surgery.&#x0D; Bangladesh J Otorhinolaryngol 2022; 28(1): 50-55

Sensitivity to Deaf Culture Among Otolaryngology and Audiology Trainees.

The Deaf community is an ethnolinguistic minority group. Low sensitivity to Deaf culture contributes to health disparities among Deaf patients. This study determines the level of sensitivity to Deaf culture among otolaryngology-head and neck surgery (OHNS) and audiology trainees. Cross-sectional survey study of OHNS and audiology trainees from 10 large US institutions. Trainees were queried on their exposure to and comfort with Deaf patients and their education on, attitude toward, and awareness and knowledge of Deaf culture. Sensitivity to Deaf culture was operationalized as awareness and knowledge of Deaf culture. These were assessed using a 35-item instrument that was previously developed using a d/Deaf community-based participatory approach to research. We used T-tests to compare the sample to previous samples of medical students with training in Deaf culture (MS-TDCs) and general practitioners (GPs). There were 91 completed surveys (response rate 44.5%). Almost all were aware of Deaf culture (97.8%). The mean knowledge score was 55.0% (standard deviation (SD) 13.4%), which was significantly higher than that for GPs at 43.0% (SD 15.0%) (95% confidence interval 8.1%, 15.8%, P < .0001) but significantly lower than that for MS-TDCs at 69.0% (SD 13.0%)(CI -20.3%, -7.6%, P < .0001). Knowledge scores were comparable for OHNS and audiology trainees (P = .09). This sample of OHNS and audiology trainees was more sensitive to Deaf culture than GPs but less sensitive than MS-TDCs. Developing specialty-specific education may be warranted. 4.

#Laryngology: A Standardized Hashtag Ontology

In the past decade, there has been a rise in social media applications and usage among individuals in the otolaryngology- head and neck surgery (OHNS) community. Hashtags (#), used to identify posts relating to similar topics, are utilized to search medical information, build a network, find providers, and discuss research. Previous OHNS literature in this arena includes a standard ontology, or list of hashtags, developed for the otology subspecialty. To date, the ontology of laryngology hashtags has not been created. The objective of this study is to propose a standardized ontology to use when discussing topics in laryngology on social media to maximize reach and effect. Using a combination of previously published techniques, along with laryngology specific adjustments, the authors developed a list of suggested hashtags. An initial list was systematically culled from laryngology Instagram accounts including academic programs, laryngology influencers (fellowship-trained laryngologists with publicly available professional accounts with greater than 500 followers), and professional societies/conferences. The list was abbreviated using current rate of use, specificity, and expert opinion. These were then categorized to include general terms, diseases and diagnoses, and treatment strategies RESULTS: Across all culled Instagram posts, there were 240 unique laryngology hashtags used and 1152 total hashtags were applied. The authors derived unique terms to be included in the ontology for laryngology by expert opinion of fellowship-trained laryngologists. Laryngology is in the early stages of utilization of social media. Developing a specific ontology of hashtags to be used will optimize the reach and connections of term specific searches.

Surgical Exposure and Competence in Performing Open Tracheostomy

Background: Advancements in airway procedures and intensive care medicine have resulted in a reduction in open tracheostomy (OT) performed annually which could affect the training of residents. The aim of this study is to highlight the otolaryngology-head-and-neck surgery (OHNS) trainees' perception of their surgical exposure and competency in performing OT. Methodology: A cross-sectional questionnaire-based study (using a 22-item previously validated, peer-reviewed, and published questionnaire) conducted from June 2019 to February 2020 of OHNS residents training in multiple hospitals in the two metropolitan cities. Results: The response rate was 54% (which represents n = 67 out of 125 in both cities). There were 35 juniors (52.2%) and 32 seniors (47.8%). Thirty (44.8%) residents estimated that there are ≤50 tracheostomies/year in their hospital. Only 6% of the residents reported scheduled teaching regarding OT, and only one-third (34.3%) were actually aware of the different types of cannulas and postoperative care. Conclusion: The reason behind the lower confidence of trainees is likely multifactorial, and requires restructuring of the training program to improve the confidence of graduating trainees.

Proportion of Thyroid Malignancy in Simple Multi-nodular Goiter: A Prospective Observational Study in Rajshahi Medical College Hospital

Background: Thyroid swelling is a common clinical problem throughout the world. Most of the swellings are benign but someare malignant. Epidemiologically ascertained risk factors for thyroid carcinoma are ionizing radiation, presence of thyroidadenoma and multi-nodular goiter. Objectives: To determine the proportion and type of thyroid carcinoma in simple multi-nodular goiter after surgical resectionon histopathological basis.Materials and methods: This prospective observational study was carried out in the Department of Surgery and Otolaryngology and Head neck surgery of Rajshahi Medical College Hospital from January 2015 to December 2016.The studypopulation consisted of 200 patients who were diagnosed as a simple multi-nodular goiter. Among them 60 samples were fromsurgery and 140 samples from Head neck and otolaryngology wards. All the patients were admitted through OPD with routineplus investigations specific to thyroid including thyroid profile, ultrasonography of neck, FNAC of dominant nodule beforebeing subjected to surgery. Results: Among 200 cases which were included in this study 22 (11%) containing foci of malignancy. Incidence of malignancycommonly occurs in females, papillary carcinoma is being the commonest entity. Conclusion: The incidence of malignancy in simple multi-nodular goiter in this study was 11% that is quite high. So, peopleshould be educated and encouraged to attend the thyroid clinics for proper evaluation and early diagnosis of malignancy.

Retrospective Analysis of Neck Masses Diagnosed by Histopathology from Chattogram General Hospital

Background: Neck masses are found in all age groups from many causes, ranging from congenital to acquired pathology. There is a wide variation in the presentation of neck masses concerning its site of origin, clinical presentation, and the nature of the progression of the disease. This study was performed to have an idea about the prevalence of various neck masses according to age and sex so that it would help us in diagnosing the neck masses. Materials and methods: This retrospective study was performed in the Department of Otolaryngology and Head Neck Surgery, Chattogram General Hospital, Chattogram from July 2018 and June 2019, over 97 patients presented with neck mass. Results: Of 97 cases 69.1% were female and range from 7-77 years. The maximum case holding age group was 21- 30 years (26.8%). The histopathological diagnosis of the neck masses was inflammatory in 68 (70.1%), congenital in 5 (5.2%) and neoplastic in 24 (24.7%) cases. Chronic granulomatous lymphadenitis was the most common inflammatory lesion (50.5%) and a branchial cyst was the most common congenital mass (2.2%). Neoplastic masses were malignant in 10 (10.3%) and benign in 14 (14.4%) cases. The most common malignant neoplastic mass was a follicular carcinoma (6.2%), and the most common benign neoplastic mass was goitre (12.4%). Conclusions: Cervical lymphadenopathy was the most commonly encountered neck mass. Most of the neck masses are benign. Out of these cervical lymph nodes, tubercular lymphadenopathy was most common. JCMCTA 2022 ; 33 (1) : 21-24

Development of a Questionnaire to Assess the Mothers Knowledge and Attitude towards Hearing Loss in Children

Objective: The support from mothers towards children with hearing loss is important for an early identification, diagnosis and intervention. Attempts at exploring the existing knowledge and attitude among mothers are crucial, which may lead to a greater benefit for the children and overall satisfaction for the child and the family. Thus, the present study was attempted to explore the knowledge and attitude of mothers towards children with hearing loss through the use of a valid and reliable questionnaire developed for this purpose in Malay-language. Methods: Questionnaire was developed based on past literature on knowledge, attitude and focus group discussions (FGD) which involved a representative from primary health care providers, ear, nose and throat (ENT) surgeon and audiologists. Translations follow a forward-backward procedure, independently carried out by two native-speakers of the target language. Translated questionnaires have undergone a pilot testing which involved 30 Malaysian mothers who visited the health clinics. The internal consistency of the two main domains (knowledge and attitude) was computed by the Cronbach’s Alpha coefficient to assess the reliability of the newly developed questionnaire. Results: The range of Cronbach’s Alpha showed a considerable consistency for both the knowledge and attitude with Cronbach’s Alpha of 0.77 and 0.78, respectively. Conclusion: The questionnaire regarding the knowledge and attitude of mothers towards children with hearing loss is a reliable and valid instrument. This research introduced the Malay-language version of the knowledge and attitude questionnaire as the first formal validated questionnaire and confirmed a high reliability and validity for the evaluation of mother’s knowledge and attitude towards children with hearing loss.

An unusual single paraglottic space neurofibroma: A case report and literature review.

BackgroundNeurofibromas are benign peripheral nerve sheath tumours, formed by a wide variety of different kinds of cells and matrixes. Airway neurofibromas are extremely rare and minimal cases have been described in the literature. Endoscopic surgical removal is considered challenging due to the infiltrating character of the lesion.Case presentationWe describe the clinical case of a gentleman, with a left paraglottic space neurofibroma, who presented with dyspnoea and voice changes. He had his neurofibroma removed endoscopically under general anaesthesia.MethodsThe case was analysed and discussed on this gentleman's presentation. However, the diagnosis was set only after the histology report was released. A literature review was performed to explore presentation and management.ConclusionNeurofibromas have extremely low prevalence in the airway. The size of the benign tumour in our case was impressive and the recovery of the gentleman post-operatively was rapid.

Microsurgical training using an ex-vivo model: microscope vs 3D exoscope.

SUMMARYObjectiveThe aim of this study is to evaluate the feasibility of the 3D exoscope in a microvascular anastomosis training setting and compare it with the gold-standard technique using the operating microscope (OM).MethodsParticipants were recruited among otorhinolaryngology head and neck surgery (OHNS) residents of two tertiary care hospitals. Trainees were asked to complete 4 microvascular end-to-end anastomoses on chicken thighs with the OM and VITOM 3D exoscope. The performances were scored by experienced microvascular surgeons; an objective evaluation of the anastomosis and a subjective assessment of the workload were conducted.Results8 OHNS residents were recruited. Considering the amount of time needed to complete (TTC) the anastomosis, an improvement was shown by all the participants throughout the training program. The objective evaluation of the anastomosis did not show a significant difference. No significant differences were found by analyzing the subjective workload with the different tools.ConclusionsThis article represents the first attempt to compare the use of the OM and the 3D exoscope during training for microsurgery. The results of our study demonstrate the noninferiority of microsurgical training obtained using the 3D exoscope compared to that offered by the OM.

Italian validation of the Neck Dissection Impairment Index questionnaire.

SUMMARYObjectiveThe Neck Dissection Impairment Index (NDII) questionnaire is a useful and validated Quality of Life (QoL) evaluation instrument in patients undergoing major head-neck surgery. Its English version has been used in several studies in the last years. The aim of this work is to validate the NDII in Italian for both patient assessment and future studies.Materials and methodsCross-cultural adaptation of the NDII was performed using standard techniques. Items of the original NDII were translated into Italian by a professional translator and two bilingual investigators. A final consensus version was obtained and given to two professional translators to produce a literal translation into English. The two translators and an expert committee synthesised the results of the translations in an English back-translated version that was compared with the original to check that they had the same semantic value.ResultsFinally, a total of 42 patients completed both copies of the translated questionnaires. Internal consistency proved to be excellent, with Cronbach’s alpha = 0.95.ConclusionsThe NDII was successfully translated into Italian and its use was easy for patients. The translation of the NDII can represent a useful tool for individual patient assessment and future research.

Study the demographic, clinical and surgical outcomes of endoscopic dacryocystorhinostomy

This study was done with an aim to study the demographic, clinical and surgical outcomes of Endoscopic Dacryocystorhinostomy. The records of patients who underwent Endoscopic DCR in the last five years were retrieved from the archival records of Department of Otorhinolaryngology and Head-Neck Surgery, K.G.M.U and were reviewed for demographic data, laterality, pre-operative complaints, co-morbidities, clinical and surgical profiles, adjunctive procedures, complications, and success rates at the last follow up. Result: The distribution of cases according to operation type is shown in table-7. Among the cases, Endoscopic DCR Left operation was performed in 94 (41.6%) cases while Endoscopic DCR Right operation was performed in 131 (58.0%) cases. There was one case operated with Endoscopic Bilateral DCR. On comparing pre to post op tearing status, it was found that at pre op the mean tearing score was 5.80±2.02 which was reduced to 1.17±1.35 at post op. So a mean reduction of 4.63±0.12 was observed which was significant statistically (p&lt;0.001). Conclusion: Endoscopic DCR can be adopted the first-line surgical procedure for the treatment of acquired Nasolacrimal duct obstruction. Endoscopic DCR avoids external scar, endoscopic visualization and assessment can be done immediately with correction of pathology including endonasal pathologies (DNS, turbinate hypertrophy etc.).