[Endonasal and endocanalicular dacryocystorhinostomy by diode laser. Preliminary results].
OBJECTIVE
To describe the surgical technique and to evaluate the clinical results after having performed the transcanalicular and endocanalicular dacryocystorhinostomies by diode laser, including the advantages and limits of this technique.


METHODS
34 were performed by diode laser in patients with clinical history of epiphora, with or without mucopurulent secretion, for nasolacrimal duct obstruction. The study was prospective, interventional, non randomized and non comparative. Diode laser was used to realize vaporization of lacrimal sac, osteotomy and vaporization with coagulation of nasal mucosa. The mean of surgical time was 15 minutes (range 7 to 29 minutes). Bicanalicular intubation was performed with a silicone tube and prolene filament for two months in all cases. Postsurgical follow-up was between 4 and 11 months. The degree of epiphora was evaluated by the Munk scale and lacrimal permeability was evaluated by endoscopic functional staining test in all cases.


RESULTS
Out of the 34 DCR-EDN+ENC that were performed, 32 cases (94.11%) remain asymptomatic. Two of them (5.88%) required endonasal dacryocystorhinostomies by drilling, because the bony perforation was impossible to achieve by laser fiber. Two cases (5.88%) presented fibrosis and lacrimal and lower canaliculi obstruction, without epiphora because the superior canaliculi was permeable.


CONCLUSIONS
Endonasal and endocanalicular dacryocystorhinostomy technique performed by diode laser is a valid method. It does not cause cutaneous scarring, it decreases thermic canalicular damage, it respects the lacrimal pump, it minimizes pain and bleeding, it needs less surgical time and it has turned into an out-patient procedure with a minimal surgical and postsurgical morbility.
Alañón Fernández
M A
MA
Hospital Clínico San Cecilio, Granada. miguelaaf@msn.com
Alañón Fernández
F J
FJ
Martínez Fernández
A
A
Cárdenas Lara
M
M
Rodríguez Domínguez
R
R
Ballesteros Navarro
J M
JM
Sainz Quevedo
M
M
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003607:Dacryocystitis / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000295:instrumentation*; D005260:Female; D006801:Humans; D053685:Laser Therapy / Q000379:methods*; D007834:Lasers / Q000145:classification*; D008297:Male; D008875:Middle Aged