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Endoscopic and External Dacryocystorhinostomy: Long Term Result from a Tertiary Center in Portugal

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Abstract

Dacryocystorhinostomy is the gold-standard for distal lacrimal obstructions. This study aims to report the demography, clinical presentation, influence of agger nasi opening, uncinectomy and septoplasty, the use of silicone stent tubes, complications and success of endoscopic and external dacryocystorhinostomy over a period of 11 years. Retrospective review of clinical records, from January 2012 to December 2022, at a tertiary center in Portugal. A total of 249 procedures, 6 external and 243 endoscopic, were performed, including 39 revision cases. There was a female predominance (79.9%) with a mean age at diagnosis of 66.4 years. Recurrent acute dacryocystitis, reported by 33.3%, was associated with higher success (p = 0.053). Agger nasi opening, uncinectomy and septoplasty were performed in 17.7%, 6.0% and 15.3% respectively, although associated with higher success rates, no statistically significant difference was found. Minor complication rates for both external and endoscopic approach was 33.3% and 32.1% respectively. Functional and anatomical success was 100% and 83.3%, respectively, for external dacryocystorhinostomy, and 91.4% and 85.1%, respectively, for endoscopic dacryocystorhinostomy. Revision surgery was associated with a worse anatomical success (p = 0.05). Endoscopic dacryocystorhinostomy is an effective and safe alternative to the external approach. Minor procedures can increase the success rate, but multicentre studies need to be performed for a statistically significant result.

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Authors and Affiliations

  1. Centro Hospitalar de Lisboa Ocidental, Lisbon, Portugal

    Kaamil Gani, Kaamil Gani, Luís Castelhano, Filipe Correia, Luís Roque Reis & Pedro Escada

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  1. Kaamil Gani
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  2. Luís Castelhano
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  3. Filipe Correia
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  4. Luís Roque Reis
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  5. Pedro Escada
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Correspondence to Kaamil Gani.

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The authors did not receive support from any organization for the submitted work.The authors have no relevant financial or non-financial interests to disclose.

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Considering this is a non-interventional study where data was retrospectively obtained, analysed and anonymized, the need for ethics committee approval was waived.

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Gani, K., Castelhano, L., Correia, F. et al. Endoscopic and External Dacryocystorhinostomy: Long Term Result from a Tertiary Center in Portugal. Indian J Otolaryngol Head Neck Surg 76, 1613–1618 (2024). https://doi.org/10.1007/s12070-023-04368-y

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