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Aim <p>To study intranasal causes of failure of external dacryocystorhinostomy (DCR).</p> Methods <p>A retrospective analysis of clinical data from transnasal endoscopic results following unsuccessful external DCR was done. Evaluation of 40 patients with external dacryocystorhinostomy failure; based on patient-reported symptoms and saccharine test, and objectively through syringing patency, functional endoscopic dye test, and endonasal endoscopic evaluation.</p> Results <p>Endoscopic findings showed: 14 cases with intranasal adhesions, 6 with septal Deviation, 3 with concha bullosa, 2 with abnormal fistula size, 4 with rhinosinusitis, 2 with granulations, 4 with a closed ostium, and 5 cases where no clear cause was found (functional failure). In 35 patients, a negative dye clearance test and absence of fluorescein on irrigation were noted. Delayed dye clearance but fluorescein detection occurred in 5 patients (functional failure).</p> Conclusions <p>Nasal endoscopy plays a crucial role in diagnosing the causes of external DCR failure and is essential both before and after surgery. DCR should be performed through teamwork between a rhinologist and ophthalmologist. Understanding mucociliary clearance in the lacrimal pathway can enhance surgical outcomes and guide the decision on whether to use a small or large fenestra technique. Invasive and efficacious alternative compared to Conventional dissection tonsillectomy.</p>

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Importance of Endoscopic Nasal Evaluation of Unsuccessful Outcomes Following an External DCR

  • 期刊论文

  • 发表日期：

    2025年6月12日

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  • Roli Vachhani,
  • Yamini Gupta,
  • Vipin Kushwaha

摘要

Aim

To study intranasal causes of failure of external dacryocystorhinostomy (DCR).

Methods

A retrospective analysis of clinical data from transnasal endoscopic results following unsuccessful external DCR was done. Evaluation of 40 patients with external dacryocystorhinostomy failure; based on patient-reported symptoms and saccharine test, and objectively through syringing patency, functional endoscopic dye test, and endonasal endoscopic evaluation.

Results

Endoscopic findings showed: 14 cases with intranasal adhesions, 6 with septal Deviation, 3 with concha bullosa, 2 with abnormal fistula size, 4 with rhinosinusitis, 2 with granulations, 4 with a closed ostium, and 5 cases where no clear cause was found (functional failure). In 35 patients, a negative dye clearance test and absence of fluorescein on irrigation were noted. Delayed dye clearance but fluorescein detection occurred in 5 patients (functional failure).

Conclusions

Nasal endoscopy plays a crucial role in diagnosing the causes of external DCR failure and is essential both before and after surgery. DCR should be performed through teamwork between a rhinologist and ophthalmologist. Understanding mucociliary clearance in the lacrimal pathway can enhance surgical outcomes and guide the decision on whether to use a small or large fenestra technique. Invasive and efficacious alternative compared to Conventional dissection tonsillectomy.