Results of Endoscopic Endonasal Dacryocystorhinostomy; Necessity of Teamwork and Patient Selection

Our aim was to evaluate the clinical results of endoscopic endonasal surgical dacryocystorhinostomy (EES-DCR) as team work by an ophthalmologist and an ear-nose-throat (ENT) surgeon and the appropriate selection of the patients. All candidates for DCR underwent computed tomography (CT) scan of the paranasal sinuses (PNS). Patients who did not want a scar on the medial canthus skin or who had intranasal problems received EES-DCR, which was performed as team work by an ophthalmologist and an ENT surgeon. Surgical success was the resolution of epiphora (i.e., functional success) and free passage of the fluid on irrigation (i.e., anatomical success) by six months after surgery. One hundred twenty-eight patients underwent EES-DCR. Six months after the operation, six patients had surgical failure (three cases of anatomical failure and three cases of functional failure); the success rate was therefore 95.3%. The most common intranasal problems that led to EES-DCR were septal deviation, sinusitis, close proximity of the agger nasi to the lacrimal bone, and concha bullosa; moreover, 15.5% of patients selected EES-DCR for cosmetic reasons. In conclusion, Cooperation between ophthalmologists and ENT surgeons in the preoperative assessment of patients with epiphora before EES-DCR increases its success rate, and it can replace external DCR in some patients.