Abstract

Background: stenosis of nasolacrimal duct with the resultant stagnation of lacrimal fluid and subsequent infection is the most common cause of dacryocystitis. Dacryocystorhinostomy stands as the gold standard in treatment of chronic dacryocystitis. It can be performed via 2 approaches: External and Endonasal.

Aim: This study was done to compare the This study was done to compare the success rates and merits and demerits between External DCR and Endonasal Endoscopic DCR

Method: It was a single-center prospective randomized comparative interventional study completed in the duration of two years done in the Upgraded Department of Ophthalmology & Department of Otorhinolryngology of MGMMC & MY Hospital. A total of 40 cases with chronic dacryocystitis presenting with NLD obstruction based on symptomatic, clinical and radiologic grounds were included in the study and divided randomly into 2 groups. Each group subjected to External and Endoscopic DCR respectively.

Result: There were no significant difference in success rates between both the groups. However variation was noted in merits and demerits of both the techniques of external and endonasal DCR .The study revealed that after a mean follow-up of 3 months ,difference in success rates  (patency)  between these groups were statistically insignificant ( X² test =2.264 ,P = 0.322).(Table 3)

Conclusion: Although statistically insignificant, At the end of 3 months follow-up period, the success rate was highest in External DCR (90%) in comparison to Endoscopic DCR (80%). But Endoscopic DCR is a minimally invasive scarless surgery with cosmetically more acceptable by young patients and has less intraoperative bleeding as it is a direct approach to the lacrimal sac.

Keywords: dacryocystorhinostomy, dacryoscytitis, nasolacrimal duct.