Advertisement

Adult Endoscopic Endonasal Dacryocystorhinostomy

  • Angela Maria Dolmetsch
Chapter

Abstract

Epiphora or tearing is a common symptom of diverse etiology. One of the causative factors is blockage of the nasolacrimal duct, which provides tear drainage from the lacrimal sac to the nasal cavity. The treatment of choice for nasolacrimal duct obstruction is the dacryocystorhinostomy which bypasses the obstruction in the duct by creating a direct aperture from the lacrimal sac to the nose. The traditional approach is the external dacryocystorhinostomy (Ext-DCR) which has been considered in the past the “gold standard” of treatment. However, in the previous decades, the endoscopic endonasal dacryocystorhinostomy (EndoDCR) has been found to have equally or even better success rates than the external route. Furthermore, the EndoDCR has many potential advantages over the Ext-DCR. Current concepts, applied surgical anatomy, surgical techniques, indications and contraindications, and complications will be discussed.

Keywords

Epiphora Dacryocystorhinostomy Endoscopic Endonasal Tearing Dacryocystitis Nasal mucosal flaps Sump syndrome Osteotomy fibrosis Lacrimal surgery 

Abbreviations

CNLDO

Congenital nasolacrimal duct obstruction

CO2

Carbon dioxide

DCR

Dacryocystorhinostomy

EndoDCR

Endonasal dacryocystorhinostomy

ENL-DCR

Endonasal laser dacryocystorhinostomy

Ext-DCR

External dacryocystorhinostomy

KTP

Potassium titanyl phosphate

MMC

Mitomycin C

PANDO

Primary acquired nasolacrimal duct obstruction

RAI

Radioactive iodine therapy

SANDO

Secondary acquired nasolacrimal duct obstruction

YAG

Yttrium aluminum garnet

References

  1. 1.
    Wu W, Yan W, MacCallum JK, Tu Y, Jiang AC, Yang Y, Xiao T, Li J, Wang Q, Qu J. Primary treatment of acute dacryocystitis by endoscopic dacryocystorhinostomy with silicone intubation guided by a soft probe. Ophthalmology. 2009;116(1):116–22.CrossRefGoogle Scholar
  2. 2.
    Toti A. Nuovo metodo conservatore di cura radicale delle suppurazioni croniche del sacco lacrimale (dacriocistorinostomia). Clin Mod. 1904;10:385–7.Google Scholar
  3. 3.
    Woog JJ, Kennedy RH, Custer PL, Kaltreider SA, Meyer DR, Camara JG. Endonasal dacryocystorhinostomy. A report by the American Academy of Ophthalmology. Ophthalmology. 2001;108:2369–77.CrossRefGoogle Scholar
  4. 4.
    Madge SN, Chan W, Malhotra R, Ghabrial R, Floreani S, Wormald PJ, Tsirbas A, Selva D. Endoscopic dacryocystorhinostomy in acute dacryocystitis: a multicenter case series. Orbit. 2011;30(1):1–6.CrossRefGoogle Scholar
  5. 5.
    Jain S, Ganguly A, Singh S, Mohapatra S, Tripathy D, Rath S. Primary nonendoscopic endonasal versus delayed external dacryocystorhinostomy in acute dacryocystitis. Ophthalmic Plast Reconstr Surg. 2017;33(4):285–8.CrossRefGoogle Scholar
  6. 6.
    Lee TS, Woog JJ. Endonasal dacryocystorhinostomy in the primary treatment of acute dacryocystitis with abscess formation. Ophthalmic Plast Reconstr Surg. 2001;17(3):180–3.CrossRefGoogle Scholar
  7. 7.
    Szubin L, Papageorge A, Sacks E. Endonasal laser-assisted dacryocystorhinostomy. Am J Rhinol. 1999;13:371–4.CrossRefGoogle Scholar
  8. 8.
    Dolman PJ. Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology. 2003;110:78–8.CrossRefGoogle Scholar
  9. 9.
    Fayet B, Racy E, Assouline M. Systematic unciformectomy for a standardized endonasal dacryocystorhinostomy. Ophthalmology. 2002;109(3):530–6.CrossRefGoogle Scholar
  10. 10.
    McDonogh M, Meiring JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol. 1989;103:585–7.CrossRefGoogle Scholar
  11. 11.
    Kong YT, Kim TI, Kong BW. A report of 131 cases of endoscopic laser lacrimal surgery. Ophthalmology. 1994;101:1793–800.CrossRefGoogle Scholar
  12. 12.
    Lee JJ, Lee HM, Lim HB, Seo SW, Ahn HB, Lee SB. Learning curve for endoscopic endonasal dacryocystorhinostomy. Korean J Ophthalmol. 2017;31(4):299–305.CrossRefGoogle Scholar
  13. 13.
    Caldwell GW. Two new operations for obstruction of the nasal duct, with preservation of the canaliculi, and with an incidental description of a new lachrymal probe. Am J Ophthalmol. 1893;10:189–93.Google Scholar
  14. 14.
    West JM. A window resection of the nasal duct in cases of stenosis. Trans AM Opthalmol Soc. 1909–1911;12:654–8.Google Scholar
  15. 15.
    Massaro BM, Gonnering S, Harris GJ. Endonasal laser dacryocystorhinostomy. A new approach to nasolacrimal duct obstruction. Arch Ophthalmol. 1990;108:1172–6.CrossRefGoogle Scholar
  16. 16.
    Harish V, Benger RS. Origins of lacrimal surgery, and evolution of dacryocystorhinostomy to the present. Clin Exp Ophthalmol. 2014;42(3):284–7.CrossRefGoogle Scholar
  17. 17.
    Gonnering RS, Lyon DB, Fisher JC. Endoscopic laser-assisted lacrimal surgery. Am J Ophthalmol. 1991;111:152–7.CrossRefGoogle Scholar
  18. 18.
    Woog JJ, Metson R, Puliafito CA. Holmium:YAG endonasal laser dacryocystorhinostomy. Am J Ophthalmol. 1993;116:1–10.CrossRefGoogle Scholar
  19. 19.
    Reifler DM. Results of endoscopic KTP laser-assisted dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 1993;9:231–6.CrossRefGoogle Scholar
  20. 20.
    Metson R. The endoscopic approach for revision dacryocystorhinostomy. Laryngoscope. 1990;100:1344–7.CrossRefGoogle Scholar
  21. 21.
    Seppa H, Grenman R, Hartikainen J. Endonasal CO2-Nd:YAG laser dacryocystorhinostomy. Acta Ophthalmol. 1994;72:703–6.CrossRefGoogle Scholar
  22. 22.
    Tutton MK, O’Donnell NP. Endonasal laser dacryocystorhinostomy under direct vision. Eye. 1995;9:485–7.CrossRefGoogle Scholar
  23. 23.
    Sadiq SA, Hugkulstone CE, Jones NS, Downes RN. Endoscopic holmium:YAG laser dacryocystorhinostomy. Eye. 1996;10:43–6.CrossRefGoogle Scholar
  24. 24.
    Mickelson SA, Kim DK, Stein IM. Endoscopic laser assisted dacryocystorhinostomy. Am J Otolaryngol. 1997;18:107–11.CrossRefGoogle Scholar
  25. 25.
    Hartikainen J, Grenman R, Puukka P, Seppa H. Prospective randomized comparison of external dacryocystorhinostomy and endonasal laser dacryocystorhinostomy. Ophthalmology. 1998;105:1106–13.CrossRefGoogle Scholar
  26. 26.
    Hehar SS, Jones NS, Sadiq SA, Downes RN. Endoscopic holmium:YAG laser dacryocystorhinostomy – safe and effective as a day-case procedure. J Laryngol Otol. 1997;111:1056–9.CrossRefGoogle Scholar
  27. 27.
    Tarbet KJ, Custer PL. External dacryocystorhinostomy: surgical success, patiente satisfaction, and economic cost. Ophthalmology. 1995;102:1065–70.CrossRefGoogle Scholar
  28. 28.
    Walland MJ, Rose GE. Factors affecting the success rate of open lacrimal surgery. Br J Ophthalmol. 1994;78:888–91.CrossRefGoogle Scholar
  29. 29.
    Camara JG, Bengzon AU, Henson RD. The safety and efficacy of mitomycin C in endonasal endoscopic laser-assisted dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 2000;16:114–8.CrossRefGoogle Scholar
  30. 30.
    Knisely A, Harvey R, Sacks R. Long-term outcomes in endoscopic dacryocystorhinostomy. Curr Opin Otolaryngol Head Neck Surg. 2015;23(1):53–8.PubMedGoogle Scholar
  31. 31.
    Zengin MO, Eren E. The return of the jedi: comparison of the outcomes of endolaser dacryocystorhinostomy and endonasal dacryocystorhinostomy. Int Forum Allergy Rhinol. 2014;4:480–3.CrossRefGoogle Scholar
  32. 32.
    Huang J, Malek J, Chin D, et al. Systematic review and meta-analysis on outcomes for endoscopic versus external dacryocystorhinostomy. Orbit. 2014;33:81–90.CrossRefGoogle Scholar
  33. 33.
    Marcet MM, Kuk AK, Phelps PO. Evidence based review of surgical practices in endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction and other new indications. Curr Opin Ophthalmol. 2014;25:443–8.CrossRefGoogle Scholar
  34. 34.
    Javate RM, Campomanes BS Jr, Co ND, et al. The endoscope and the radiofrequency unit in DCR surgery. Ophthal Plast Reconstr Surg. 1995;11:54–8.CrossRefGoogle Scholar
  35. 35.
    Moore WM, Bentley CR, Olver JM. Functional and anatomic results after two types of endoscopic endonasal dacryocystorhinostomy: surgical and holmium laser. Ophthalmology. 2002;109:1575–82.CrossRefGoogle Scholar
  36. 36.
    Tsirbas A, Wormald PJ. Endonasal dacryocystorhinostomy with mucosal flaps. Am J Ophthalmol. 2003;135:76–83.CrossRefGoogle Scholar
  37. 37.
    Trimarchi M, Resti AG, Bellini C, et al. Anastomosis of nasal mucosal and lacrimal sac flaps in endoscopic dacryocystorhinostomy. Eur Arch Otorhinolaryngol. 2009;266:1747–52.CrossRefGoogle Scholar
  38. 38.
    Codere F, Denton P, Corona J. Endonasal dacryocystorhinostomy: a modified technique with preservation of the nasal and lacrimal mucosa. Ophthalmic Plast Reconstr Surg. 2010;26:161–4.CrossRefGoogle Scholar
  39. 39.
    Sonkhya N, Mishra P. Endoscopic transnasal dacryocystorhinostomy with nasal mucosal and posterior lacrimal sac flap. J Laryngol Otol. 2009;123:320–6.CrossRefGoogle Scholar
  40. 40.
    Green R, Gohil R, Ross P. Mucosal and lacrimal flaps for endonasal dacryocystorhinostomy: a systematic review. Clin Otolaryngol. 2017;42:514–20.CrossRefGoogle Scholar
  41. 41.
    Ramakrishnan VR, Hink EM, Durairaj VD, Kingdom TT. Outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation. Am J Rhinol. 2007;21(6):753–7.CrossRefGoogle Scholar
  42. 42.
    Hodgson N, Bratton E, Whipple K, Priel A, Oh SR, Fante RG, Kikkawa DO, Korn BS. Outcomes of endonasal dacryocystorhinostomy without mucosal flap preservation. Ophthalmic Plast Reconstr Surg. 2014;30(1):24–7.CrossRefGoogle Scholar
  43. 43.
    Xie C, Zhang L, Liu Y, Ma H, Li S. Comparing the success rate of dacryocystorhinostomy with and without silicone intubation: a trial sequential analysis of randomized control trials. Sci Rep. 2017;7(1):1936.CrossRefGoogle Scholar
  44. 44.
    Chong KK, et al. Randomized trial on silicone intubation in endoscopic mechanical dacryocystorhinostomy (SEND) for primary nasolacrimal duct obstruction. Ophthalmology. 2013;120:2139–45.CrossRefGoogle Scholar
  45. 45.
    Smirnov G, Tuomilehto H, Terasvirta M, et al. Silicone tubing is not necessary after primary endoscopic dacryocystorhinostomy: a prospective randomized study. Am J Rhinol. 2008;22:214–7.CrossRefGoogle Scholar
  46. 46.
    Feng YF, Cai JQ, Zhang JY, Han XH. A meta-analysis of primary dacryocystorhinostomy with and without silicone intubation. Can J Ophthalmol. 2011;46(6):521–7.CrossRefGoogle Scholar
  47. 47.
    Fayers T, Dolman PJ. Bicanalicular silicone stents in endonasal dacryocystorhinostomy: results of a randomized clinical trial. Ophthalmology. 2016;123(10):2255–9.CrossRefGoogle Scholar
  48. 48.
    Dolmetsch AM. Nonlaser endoscopic endonasal dacryocystorhinostomy with adjunctive mitomycin C in nasolacrimal duct obstruction in adults. Ophthalmology. 2010;117:1037–40.CrossRefGoogle Scholar
  49. 49.
    Cheng SM, Feng YF, Xu L, Li Y, Huang JH. Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis. PLoS One. 2013;13:8(5).Google Scholar
  50. 50.
    Li EY, Cheng AC, Wong AC, Sze AM, Yuen HK. Safety and efficacy of adjunctive intranasal mitomycin C and triamcinolone in endonasal endoscopic dacryocystorhinostomy. Int Ophthalmol. 2016;36(1):105–10.CrossRefGoogle Scholar
  51. 51.
    Dutton JJ. Atlas of oculoplastic and orbital surgery. 1st ed. Philadelphia: Lippincott Williams & Wilkins; 2013. p. 216–9.Google Scholar
  52. 52.
    Neskey D, Eloy JA, Casiano RR. Nasal, septal and turbinate anatomy and embryology. Otolaryngol Clin N Am. 2009;42(2):193–205.CrossRefGoogle Scholar
  53. 53.
    Oneal RM, Beil RJ. Surgical anatomy of the nose. Clin Plast Surg. 2010;37(2):191–211.CrossRefGoogle Scholar
  54. 54.
    Nerad JA. Clinical anatomy. In: Techniques in ophthalmic plastic surgery. 1st ed. Philadelphia: Saunders; 2010. p. 27–80.Google Scholar
  55. 55.
    Sweeney AR, Davis GE, Chang SH, Amadi AJ. Outcomes of endoscopic dacryocystorhinostomy in secondary acquired nasolacrimal duct obstruction: a case-control study. Ophthalmic Plast Reconstr Surg. 2018;34(1):20–5.PubMedGoogle Scholar
  56. 56.
    Ali MJ, Psaltis AJ, Murphy J, Wormald PJ. Powered endoscopic dacryocystorhinostomy. Ophthalmic Plast Reconstr Surg. 2015;31(3):219–21.CrossRefGoogle Scholar
  57. 57.
    Mattavelli D, Lombardi D, Ferrari M, Nicolai P. Complications of endoscopic DCR. In: Presutti L, Mattioli F, editors. Endoscopic surgery of the lacrimal drainage system. Cham: Springer; 2016.Google Scholar
  58. 58.
    Hammoudi DS, Tucker NA. Factors associated with outcome of endonasal dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 2011;27:266–9.CrossRefGoogle Scholar
  59. 59.
    Friedel ME, Earley MA, Eloy JA. Skull base defect in a patient with ozena undergoing dacryocystorhinostomy. Allergy Rhinol (Providence). 2011;2:36–9.CrossRefGoogle Scholar
  60. 60.
    Zuercher B, Tritten JJ, Friedrich JP, Monnier P. Analysis of functional and anatomic success following endonasal dacryocystorhinostomy. Ann Otol Rhinol Laryngol. 2011;120:231–8.CrossRefGoogle Scholar
  61. 61.
    Herzallah I, Alzuraiqi B, Bawazeer N, Marglani O, Alherabi A, Mohamed SK, Al-Qahtani K, Al-Khatib T, Alghamdi AJ. Endoscopic dacryocystorhinostomy (DCR): a comparative study between powered and non-powered technique. Otolaryngol Head Neck Surg. 2015;44:56.CrossRefGoogle Scholar
  62. 62.
    Shams PN, Chen PG, Wormald PJ, Sloan B, Wilcsek G, McNab A, Selva D. Management of functional epiphora in patients with an anatomically patent dacryocystorhinostomy. JAMA Ophthalmol. 2014;132(9):1127–32.CrossRefGoogle Scholar
  63. 63.
    Jordan DR, McDonald H. Failed dacryocystorhinostomy: the sump syndrome. Ophthalmic Surg. 1993;24:692–3.PubMedGoogle Scholar
  64. 64.
    Migliori ME. Endoscopic evaluation and management of the lacrimal sump syndrome. Ophthal Plast Reconstr Surg. 1997;13:281–4.CrossRefGoogle Scholar
  65. 65.
    Coumou AD, Genders SW, Smid TM, Saeed P. Endoscopic dacryocystorhinostomy: long-term experience and outcomes. Acta Ophthalmol. 2017;95:74–8.CrossRefGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Angela Maria Dolmetsch
    • 1
    • 2
  1. 1.Clínica de Oftalmología de CaliCaliColombia
  2. 2.Pontificia Universidad JaverianaCaliColombia

Personalised recommendations