Endoscopic Dacrycystorhinostomy
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Transcript of Endoscopic Dacrycystorhinostomy
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EndoscopicDacryocystorhinostomyEndoscopicDacryocystorhinostomyProf Sajid Mirza
Dr Khalid MahidaDr Mohammad Ayub
Dr QurratulAin Paracha
Prof Sajid Mirza
Dr Khalid MahidaDr Mohammad Ayub
Dr QurratulAin Paracha
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is a commonly performed operation in
which a fistulous tract is created between
the lacrimal sac and the nasal cavity in
order to relieve the epiphora due to
nasolacrimal duct obstruction
Endoscopic DCR
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IndicationsIndications Epiphora caused byanatomicor
functional lacrimal sacornasolacrimal duct
obstruction Chronic dacryocystitis with purulentdrainage fromthe canaliculi
Inflammationofthe skinoverlyingthelacrimal sacinthe regionofthe medialcanthus
Dacryolith formation Benignlacrimal sacmass
Epiphora caused byanatomicorfunctional lacrimal sacornasolacrimal duct
obstruction Chronic dacryocystitis with purulentdrainage fromthe canaliculi
Inflammationofthe skinoverlyingthelacrimal sacinthe regionofthe medialcanthus
Dacryolith formation Benignlacrimal sacmass
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ADVANTAG
ES,A
DVANTAG
ES, Itprovidesa betteraestheticresultwithno
external scar.
Itallowsaone-stage procedure toalsocorrectassociatednasal pathologythatmaybe causative.
Itavoidsinjurytothe medial canthus and/orpathologicscar formation.
Itprovidesa betteraestheticresultwithnoexternal scar.
Itallowsaone-stage procedure toalsocorrectassociatednasal pathologythatmaybe causative.
Itavoidsinjurytothe medial canthus and/orpathologicscar formation.
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Itpreservesthe pumpingmechanismofthe orbicularis oculi muscle.
Active infectionofthe lacrimal systemisnotacontraindicationtosurgery.
Itis especiallysuperiortothe externalapproachinrevisionsurgery
Itpreservesthe pumpingmechanismofthe orbicularis oculi muscle.
Active infectionofthe lacrimal systemisnotacontraindicationtosurgery.
Itis especiallysuperiortothe externalapproachinrevisionsurgery
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Itismuch less bloodyandmessythanthe external approach.
The perioperative time isshorter.
The successrate iscomparable totheexternal approach.
Itismuch less bloodyandmessythanthe external approach.
The perioperative time isshorter.
The successrate iscomparable totheexternal approach.
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DisadvantagesDisadvantages Itrequires specialized training in nasal
endoscopic surgery.
The endoscopic equipment is anexpense.
Itrequires specialized training in nasalendoscopic surgery.
The endoscopic equipment is anexpense.
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Complications-IntraoperativeComplications-Intraoperative
Epistaxis.
Orbital fat may be exposed.
Damage to the medial rectus andsuperior oblique may cause diplopia.
Epistaxis.
Orbital fat may be exposed.
Damage to the medial rectus andsuperior oblique may cause diplopia.
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Postoperative complicationsPostoperative complications
Epistaxis
Infection in the nose or orbit
Adhesions
Pyogenicgranulomata may occur at thepuncta or the site of rhinostomy
Persistentwatering may indicate scarring ofthe rhinostoma and may require reoperation.
Epistaxis
Infection in the nose or orbit
Adhesions
Pyogenicgranulomata may occur at thepuncta or the site of rhinostomy
Persistentwatering may indicate scarring ofthe rhinostoma and may require reoperation.
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Preop. workup
Preop. workup
Opthalmological examination
ENT examination
HematologyBiochemistry
Dacryocystgraphy
Opthalmological examination
ENT examination
HematologyBiochemistry
Dacryocystgraphy
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DemographyDemography Male 08
Female 17
Total no. 25
Male 08
Female 17
Total no. 25
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Age group
Age group
15-30 = 09
30-45 = 09
45-60 = 07
15-30 = 09
30-45 = 09
45-60 = 07
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Unilateral 24 (R-17, L-08)
Bilateral 01
Prevoius failedsurgery 10
Revision 01
Unilateral 24 (R-17, L-08)
Bilateral 01
Prevoius failedsurgery 10
Revision 01
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Concomitant
Nasal
Pathology
Concomitant
Nasal
Pathology
Deviated nasal Septum 5 Deviated nasal Septum 5
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Result
Result
Improvement of symptoms
At2nd and 4th weeknosymptoms 16
NoimprovementAt4 week 01
Improvement of symptoms
At2nd and 4th weeknosymptoms 16
NoimprovementAt4 week 01
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