Comparison of different surgical methods in endonasal dacryocystorhinostomy

Abstract:

Objective: The objective of this study is to compare three different techniques applied during dacryocystorhinostomy in terms of recurrence and operative times.

Methods: Operative times and follow-up results of the patients who underwent endoscopic dacryocystorhinostomy surgery between January 2011 and April 2014 due to nasolacrimal duct occlusion were compared. Lacrimal sacs of the patients in Group 1 (n=15) were explored using gouge hammer and surrounding bony structures were dilated with diamond drilling instrument. Lacrimal sacs of the patients in Group 2 (n=11) were identified and dilated using Diamond drill. Lacrimal sacs of the patients in Group 3 (n=15), were found with the aid of a gouge hammer and enlarged using Smith-Kerrison punch forceps.

Results: There was no significant difference between Groups 1 and 2 as for recurrence rates. However, recurrence rates in Group 3 were found to be higher compared to Groups 1 and 2. Operative times demonstrated significant differences among 3 groups, with at its highest and lowest operative times detected in Groups 1 and 2, respectively.

Conclusion: With this study, it was concluded that exploration and identification of lacrimal sac using gouge hammer and expansion of the surrounding bony structure with diamond tipped drills during dacryocystorhinostomy is an improved method with relative shortness of the operative time and lower recurrence rates.