Endonasal Dacryocystorhinostomy, About 52 Cases


Authors : Maha Hakimi; Benhoummad Othmane; Youssef Rochdi; Abdelaziz Raji

Volume/Issue : Volume 6 - 2021, Issue 4 - April

Google Scholar : http://bitly.ws/9nMw

Scribd : https://bit.ly/3xVOxGY

Dacryocystorhinostomy is the procedure that marsupializes the lacrimal sac into the ipsilateral nasal cavity. This rather simple and biased definition does not summarize the rather tremendous difficulty for the surgeon to decide on the most effective surgical route to carry it out. Two surgical techniques then merge together, endonasal Dacryocystorhinostomy, a prerogative of the ENT doctor, and external Dacryocystorhinostomy, preferred by ophthalmologists. The aim of our study was therefore mainly to answer this still relevant question: Dacryocystorhinostomy by endonasal route versus by external route, when? and why? Cases: It is for this purpose that we have collected 52 cases of Dacryocystorhinostomy operated by endonasal route in the ENT department of the University hospital of Mohamed VI in the city of Marrakech in Morocco, these patients were seen over a period of 5 years, from January 2013 to January 2018; we thus included all the patients presenting with chronic lacrimation, a permeable lacrimal sac judged by a positive bone contact and having undergone exclusive endonasal surgery. Results/Discussion: Our ultimate goal was, of course, to demonstrate the functional and anatomical superiority of the endonasal route, in the end it is quite correct to say that it is a surgical technique which, unlike its counterpart, lends itself quite readily to the ambulatory surgery under local anesthesia, but not only, the endonasal route is a surgery with little or no bleeding, requiring a short recovery period and minimal morbidity. It is also fairly localized with very little collateral damage. It is also very aesthetic for patients since it is endonasal and does not require a facial scar, which is quite embarrassing for the patient. This is not all, since this approach allows the treatment of a coexisting nasal sinus pathology and the correction of anatomical nasal sinus obstacles often responsible of failures of external dacryocystorhinostomy. Despite its innumerable advantages, it would be fair to enumerate its disadvantages, although few in number, such as difficulty in locating the inside of the lacrimal sac and the common orifice or the fragility of the lacrimal mucosa which can be injured, resulting in stenosis. Conclusion: Endonasal dacryocystorhinostomy should be a first-line surgical intervention, and not just, as some consider it, a technique for surgical revision of a failure of external dacryocystorhinostomy.

Keywords : Dacryocystorhinostomy, Lacrymo-Nasal Duct,Middle Turbinate

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