European Journal of Cardiovascular Medicine

Introduction: Dacryocystitis is the inflammation of the lacrimal drainage system which presents as acute dacryocystitis or much commonly as chronic dacryocystitis. The conventional treatment for watering eyes due to Naso Lacrimal Duct (NLD) obstruction is the procedure of external dacryocystorhinostomy (DCR) which has its own limitations and disadvantages. With the introduction of high resolution endoscopes for paranasal sinuses, endoscopic endonasal DCR (EnDCR) is gaining popularity.In EnDCR the most common cause for failure of surgery is closure of rhinostoma and to prevent this silicone tube insertion is the most preferred method.  It has also been claimed that silicone tubing would improve surgical results. But studies also indicate that silicone tubing itself results in certain problems like foreign body sensation, increased granulation tissue leading to failure, prolapse of tube leading to injury to cornea, nasal migration of tube, fistula formation, pharyngitis and associated sinusitis & recurrent nose bleed. The present study was undertaken to compare the surgical results of endoscopic endonasal DCR with and without silicone stent. Aims & Objectives: To compare the success rates of endonasal dacryocystorhinostomy and evaluate the presence of post-operative changes and their effect on the outcome of the surgery in endoscopic dacryocystorhinostomy with and without stenting. Material & Methods: This Prospective randomized comparative study was carried out amongst the patients attending ENT OPD for chronic nasolacrimal duct obstruction with complaint of chronic epiphora. After obtaining approval from the IEC and informed consent of the participants, 50 patients divided into two groups of 25 each fulfilling inclusion and exclusion criteria were included in this study. Group 1 includes patients undergoing EnDCR with stenting and Group 2 includes patients undergoing EnDCR without stenting. Patients were assessed for post-operative complications like granulations, size of the neo ostium and patency of the neo ostium. Data was entered in MS Excel work sheet. Data was analyzed using appropriate statistical methods. Result This study had Female predominance in both the groups. Neither any laterality nor any major intra operative complications were observed. Duration of surgery was more in Group I which was statistically significant. Post-operative complications are seen more in group without stenting (64.0%) than in group with stenting (56%) with no statistical difference between the two groups. Granulations had no effect on the outcome of the surgery. On subjective assessment of symptoms, 92% of patients in group I and 88% of patients in group II showed improvement of symptoms post operatively. No statistical difference had been found between the results of both the groups. On objective assessment of size of the neo ostium, no statistical difference was seen between the two groups. The size of the neo ostium had no effect on the outcome of the surgery. On objective assessment, patency of the neo ostium was observed in 92% of patients in group I and 88% patients in group II with no statistical difference between the two groups. Conclusion: As success rates of the surgery with stenting and without stenting are comparable and stenting leads to increased duration of surgery and additional cost to the patient, we conclude that EnDCR without stenting is the treatment of choice for nasolacrimal duct obstruction (NLDO).