title: Endonasal laser dacryocystorhinostomy: its role in anticoagulated patients.
abstract: OBJECTIVE
  To report the results of endoscopic laser-assisted dacryocystorhinostomy in anticoagulated patients.
  
  
  METHODS
  A retrospective study of 16 consecutive anticoagulated patients with distal nasolacrimal duct obstruction treated by endoscopic laser-assisted dacryocystorhinostomy.
  
  
  METHODS
  A case note review was made of all patients treated with endoscopic laser-assisted dacryocystorhinostomy who were taking coumadin in two centers between 1993 and 2000. The parameters of age, gender, indications for surgery, surgical findings, complications, and outcome were analyzed. The mean follow-up time was 14 months (range, 9-26 mo).
  
  
  RESULTS
  Fifteen of the 16 patients who were treated had an eventual successful outcome, but 6 patients required revision surgery. The patient whose symptoms were not improved was shown to have functional epiphora. No patient had a problem with primary or secondary epistaxis, and no patient required admission. A major benefit was the lack of disruption of anticoagulant therapy.
  
  
  CONCLUSIONS
  Endoscopic laser-assisted dacryocystorhinostomy is a safe, efficient technique for the relief of distal nasolacrimal duct obstruction in anticoagulated patients. Not only does it avoid any disruption to their anticoagulant therapy, but it also can be performed as an outpatient procedure.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, University Hospital, Nottingham, UK.
authors.forename: A
authors.initials: A
authors.lastname: Smithard
authors.forename: D
authors.initials: D
authors.lastname: Wynne
authors.forename: B J G
authors.initials: BJ
authors.lastname: Bingham
authors.forename: N S
authors.initials: NS
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures; D000925:Anticoagulants / Q000009:adverse effects* / Q000627:therapeutic use; D003608:Dacryocystorhinostomy; D004724:Endoscopy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000097:blood / Q000601:surgery; D007767:Lacrimal Duct Obstruction / Q000097:blood; D053685:Laser Therapy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000097:blood / Q000209:etiology / Q000601:surgery; D012086:Reoperation; D012307:Risk Factors; D006113:United Kingdom; D014859:Warfarin / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000925:Anticoagulants; D014859:Warfarin