A Comparison of Surgical Outcomes between Small Fenestra and Large Fenestra Endoscopic Endonasal Dacryocystorhinostomy
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- Category: Vol. 77, September 2009
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A Comparison of Surgical Outcomes between Small Fenestra and Large Fenestra Endoscopic
Endonasal Dacryocystorhinostomy,ASHRAF M. KHALED, AHMAD M. MOHEE ELDEEN, RAMEZ SABRY, MOHAMAD RASHED and MOHAMAD S. AHMAD
Abstract
Objective: Endoscopic endonasal DCR is a well established technique but, there has been considerable debate in the literature about the size of the neo-ostium made during the surgery.
Materials: Between September 2005 and February 2008, 22 patients (30 sides) with persistant epiphora and/or chronic dacryocystitis underwent endoscopic DCR. They were 8 males and 14 females aged between 21 and 58 years (mean 44.3 years). The included patients were divided randomly into two equal groups each included 11 patients. Group A patients were treated with small fenestra endoscopic DCR while the group B patients were treated with large fenestra endoscopic DCR.
Results: The mean follow up period was 18.7 months (range 12-27 months). Of 15 sides in each group, 12 sides (80%) in group A and 14 sides (93.3%) in group B demon-strated primary surgical success, defined as absence of epi-phora. Obstruction of the neo-ostium by fibrous tissue or synechia was identified in 3 cases (2 in group A and 1 in group B). While one case in group A complained persistence of epiphora in the presence of patent neo ostium. This case was considered a surgical failure.
Conclusions: This study demonstrates that small and large fenestra techniques are safe and effective in the management of chronic dacryocystitis. Although the large fenestra endo-scopic DCR showed better outcome compared with small fenestra technique, it was statistically insignificant.