title: Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy.
abstract: OBJECTIVE
  The advent of the rigid endonasal endoscope and the development of functional endoscopic sinus surgery (FESS) technique have awakened interest in an endonasal endoscopic dacryocystorhinostomy (EESC-DCR) in treating nasolacrimal obstruction. This prospective, randomized study compares EESC-DCR with traditional external dacryocystorhinostomy (EXT-DCR) for their success rates, surgical duration, and postoperative symptoms.
  
  
  METHODS
  Sixty-four cases in 60 patients with primary acquired nasolacrimal sac or duct obstruction were divided into two subgroups by symptoms (simple epiphora/chronic dacryocystitis). These patients were randomized within both subgroups into two operation groups. Altogether 32 EESC-DCRs and 32 EXT-DCRs were performed. The final follow-up visit was at 1 year. The patency of the lacrimal passage was investigated by irrigation and patients were questioned about their symptoms.
  
  
  RESULTS
  The success rate at 1 year after surgery was 75% for EESC-DCR and 91% for EXT-DCR after primary surgery. The difference was not statistically significant (P = .18). The success rate after secondary surgery with a follow-up time of 1 year was 97% in both study groups. The average duration for EESC-DCR was 38 minutes, and 78 minutes for EXT-DCR, (P < .001).
  
  
  CONCLUSIONS
  EXT-DCR, when compared with EESC-DCR, appears to give a higher, although not statistically significant, primary success rate, but the secondary success rates are equal, indicating that these two different DCR techniques are acceptable alternatives.
authors.affiliation: Department of Ophthalmology, University of Turku, Finland.
authors.forename: J
authors.initials: J
authors.lastname: Hartikainen
authors.forename: J
authors.initials: J
authors.lastname: Antila
authors.forename: M
authors.initials: M
authors.lastname: Varpula
authors.forename: P
authors.initials: P
authors.lastname: Puukka
authors.forename: H
authors.initials: H
authors.lastname: Seppä
authors.forename: R
authors.initials: R
authors.lastname: Grénman
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome