I-shaped incision with mucosal flap preserving technique in endoscopic dacrocystorhinostomy

Introduction Epiphora due to nasolacrimal duct obstruction accounts for ~3% of all general ophthalmology visits. Endoscopic dacryocystorhinostomy (DCR) has become accepted as a suitable treatment for patients with obstructions of the lacrimal system at the level of the sac or below it. Modification of endoscopic DCR is realized by using the overlapping flaps between the lacrimal sac and nasal mucosa with the creation of a wide bony ostium by drilling out the bony borders of the lacrimal sac. Aim To assess the rate of patency of rhinostome after endoscopic DCR with mucosal flap preservation technique in the treatment of nasolacrimal duct obstruction. Patients and Methods The study population was 30 patients suffering from epiphora due to obstructive lacrimal drainage disorders attending the ORL clinic who were referred from the Ophthalmology Clinic in Suez Canal University Hospital. Patients included in the study had been subjected to the following procedures: full history taking, eye and ORL examinations, diagnostic procedures (dye disappearance test – Jones test I and II), routine preoperative investigations, and endoscopic DCR with mucosal preservation flap technique surgery. Results Most of the patients were women (70%). The patients’ age ranged from 18 to 65 years old. All patients complained of epiphora, 50% had punctual discharge, and 26.6% had lacrimal sac swelling before the operation. The success rate of the operation was 90%. Conclusion We conclude that the low complication and high success rate indicate that EN-DCR with a large bony ostium and large nasal mucosal flap opposed with lacrimal sac flaps can be considered as a better technique in the treatment of lacrimal system obstructions.