Impact of Posterior Mucosal Flap Management on Surgical Outcomes in Endoscopic Dacryocystorhinostomy: A Prospective Analysis
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Abstract
Background: Endoscopic dacryocystorhinostomy is a highly effective procedure, increasingly becoming a standard for relieving epiphora and infections, with techniques evolving to improve success rates.
Objective: This study evaluated the effectiveness of endoscopic dacryocystorhinostomy (DCR) for the management of acquired nasolacrimal duct obstruction, comparing procedures that preserved posterior mucosal flaps with those that did not.
Methods: Prospectively, we examined the outcomes of 50 surgical procedures performed on 46 patients presenting with epiphora due to nasolacrimal duct obstruction at the Al-Nhada Special Surgical Center. The patients were assigned to one of two groups: group A received endonasal DCR with preservation of the posterior mucosal flap, and group B underwent the procedure with its removal.
Results: Among 50 procedures, Group A comprised 29 (58%) and Group B 21 (42%), including four bilateral cases. Overall subjective improvement was reported in 93.1% of patients. In group A, 94.1% showed patent rhinostomy on endoscopic follow-up at one month, with one obstruction; group B had two obstructions. Granulation tissue and synechia occurred in two patients in group A (one obstruction) and six in group B (two obstructions). No intraoperative complications were observed.
Conclusion: : Endoscopic techniques are a safe and effective treatment for nasolacrimal duct (NLD) obstruction. Our findings indicate no significant difference in surgical outcomes between endoscopic endonasal DCR performed with preservation of the mucosal flaps and without. Furthermore, the size of the created intranasal ostium did not correlate with its functional success.
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Endoscopic Dacryocystorhinostomy; Mucosal Flap; Nasolacrimal Duct Obstruction; Surgical Outcomes; Ostium.
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