Endonasal Endoscopic Dacryocystorhinostomy with and Without Stents-A Comparative Study

The study aims to compare the outcomes of endonasal endoscopic dacryocystorhinostomy (DCR) with and without nasolacrimal stents. A prospective randomized comparative study involving fifty patients, divided into two groups of 25 patients each. Group A consists of patients who underwent endoscopic DCR with silicon stent and group B consists of patients who underwent endoscopic DCR without stent. Patients were regularly followed up at 1st week, 6th week, 10th week and at the end of 5th month postoperatively. The silicone stents were removed at 6th postoperative week. Using statistical analysis results between the two groups were compared. Post-operative improvement in nasolacrimal duct obstruction and epiphora was seen in both the groups. Age of the patients ranged from 18 to 69 years with most of the patients in the age group of 40 to 49 years (46% N = 23, 12 in group A and 11 in group B). 88% of the patients were females. (N = 44, 21 in group A and 23 in group B) and 12% were males (N = 6, 4 in group A and 2 in group B). The disease was more commonly observed on the left side with 72% of the cases (N = 36, 19 in group A and 17 in group B) and 28% (N = 14, 6 in group A and 8 in group B) on the right side. In group A, (En DCR with silicone stent) 96% of the cases were successful while 4% resulted in failure whereas in group B (En DCR without stent) 92% of the cases were successful while 8% resulted in failure. Endoscopic DCR is simple and safe method. It is minimally invasive procedure as it is a direct approach to the sac. Cosmetically it is acceptable as there is no external scar. Endoscopic dacryocystorhinostomy with canalicular silicone intubation for shorter duration (6 weeks) is a safe and successful procedure for the treatment of nasolacrimal duct obstruction. Close follow up immediately after surgery is needed to reduce the failure rate. Regular post-operative follow up is necessary and any defect like synechia and granulation tissue formation can be released at follow up period thus increasing the success rate. En DCR has a good success rate with and without stenting of 96% and 92% respectively.