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<p>Endoscopic dacryocystorhinostomy (EN-DCR) is the preferred surgical treatment for nasolacrimal duct obstruction. Various instruments are used to create the bony osteotomy, most commonly powered drill and Kerrison punch. However, the optimal technique remains debated. The objective of the study is to compare the efficacy, operative time, complications, and surgical outcomes of powered drill versus Kerrison punch techniques in endoscopic dacryocystorhinostomy. This retrospective study included patients who underwent EN-DCR between October 2023 and January 2025. Patients were divided into two groups based on the osteotomy technique: powered drill (Group A) and Kerrison punch (Group B). Outcomes were assessed using subjective symptom relief, endoscopic patency, and lacrimal syringing. Operative time and complications were compared. Thirty-one patients were included (23 females, 8 males). The overall success rate was 87%. The success rate was higher in the Kerrison punch group (94.1%) compared to the powered drill group (78.5%). Mean operative time was shorter in the Kerrison punch group (≈85–90&#xa0;min) compared to the powered drill group (≈110–120&#xa0;min). Complications were minor and comparable between both groups. Both techniques are safe and effective for EN-DCR. However, the Kerrison punch technique demonstrated higher success rates and shorter operative time, supporting the concept that minimal tissue trauma and mucosal preservation are critical for long-term success.</p>

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Powered Drill vs Kerrison Punch in Endoscopic DCR: a Retrospective Study

  • 期刊论文

  • 发表日期：

    2026年7月28日

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  • J. S. Arunkumar,
  • Akshata Nagaral,
  • Shraddha Pai,
  • Santosh S. Garag,
  • Shivaprasad Karanth,
  • Linoshka Gomes

摘要

Endoscopic dacryocystorhinostomy (EN-DCR) is the preferred surgical treatment for nasolacrimal duct obstruction. Various instruments are used to create the bony osteotomy, most commonly powered drill and Kerrison punch. However, the optimal technique remains debated. The objective of the study is to compare the efficacy, operative time, complications, and surgical outcomes of powered drill versus Kerrison punch techniques in endoscopic dacryocystorhinostomy. This retrospective study included patients who underwent EN-DCR between October 2023 and January 2025. Patients were divided into two groups based on the osteotomy technique: powered drill (Group A) and Kerrison punch (Group B). Outcomes were assessed using subjective symptom relief, endoscopic patency, and lacrimal syringing. Operative time and complications were compared. Thirty-one patients were included (23 females, 8 males). The overall success rate was 87%. The success rate was higher in the Kerrison punch group (94.1%) compared to the powered drill group (78.5%). Mean operative time was shorter in the Kerrison punch group (≈85–90 min) compared to the powered drill group (≈110–120 min). Complications were minor and comparable between both groups. Both techniques are safe and effective for EN-DCR. However, the Kerrison punch technique demonstrated higher success rates and shorter operative time, supporting the concept that minimal tissue trauma and mucosal preservation are critical for long-term success.