Clinical Evaluation of Endoscopic Endonasal Dacryocystorhinostomy

Purpose: To evaluate the factors which affect the success rates of endoscopic endonasal dacryocystorhinostomy. Methods: We analyzed 74 patients (95 eyes) who had undergone endoscopic endonasal dacryocystorhinostomy in Gachon Medical School, Gil Hospital between March 2000 and March 2003, and who were followed up for at least 6 months (range 613 months, mean 7.4 months). Surgical procedures, success rates, and complications of endoscopic endonasal dacryocystorhinostomy were evaluated. Results: The primary success rate was 88.4% (84 of 95 cases) and the final success rate was 93.7% (89 of 95 cases), after 5 successful cases were added following revision. The success rate of the group with mitomycin C was statistically significantly higher than that of the group without it, but the interval of silicone tube removal from the operation or middle turbinectomy did not have any statistically significant effect on the success rate. In order of frequency, the postoperative complications were granuloma formation, nasal mucosa synechia, silicone tube prolapse, and membranous obstruction. Conclusions: Endoscopic endonasal dacryocystorhinostomy has the advantage of a similarly high success rate with external dacryocystorhinostomy and easy reoperation when performed with adequate procedures by an expert surgeon and followed up with proper postoperative management.