Khawaja Khalid Shoaib, Sabih Uddin Ahmed, Iftikhar Aslam, Syed Nadeem-ul Haq.
Dacryocystorhinostomy - is Endonasal Endoscopic Approach A Viable Option?.
Ophthalmol Update Jan ;13(2):59-61.

Objective: To analyze the per operative problems, post operative complications and success rate of dacryocystorhinostomies performed by endoscopic endonasal approach (endo DCR). Study design: Quasi - experimental study Place and duration of study: CMH Kharian and Mardan, from Jan 2008 to Dec 2011 Material and Method: In the initial ten cases, only nasal packing with 2 % xylocaine with adrenaline was done and kept for fifteen minutes. In the next ten cases, after packing, injection of the same solution was given at sac area and middle turbinate. Packing was done again for ten minutes. In rest of the cases, after packing, cautery was done instead of the injection. In all the procedures, silastic intubation and application of Mitomycin C 0.5 mg/ml for ten minutes was done. Results: A total of 35 endo DCR were done in 34 patients under general anesthesia. 3 (9%) were males and 31 (91 %) were females. Age ranged from three years to sixty three years (mean 42 + 15). Follow up ranged from 4 to 11 months (mean 6.5 + 2.5). Problems during the operation included moderate bleeding obscuring view during six (17%), difficulty in localization of sac area in five (14 %), mild bleeding on first post operative day after three (9%), nasal mucosal adhesions after one (3 %) and persistent watering after six (17 %) requiring re operation with endonasal endoscopy. Success rate was 83 % after first operation and 94% after the endo procedure. Conclusion: Complications encountered during and following endo DCR can be managed. The procedure has a good success rate.

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