title: Endoscopic dacryocystorhinostomy: creation of a large marsupialized lacrimal sac.
abstract: This retrospective study describes and evaluates the effectiveness of a modified technique of conventional endoscopic dacryocystorhinostomy (DCR) that minimizes the obstruction of a neo-ostium by creating an enlarged marsupialized lacrimal sac using mucosal flaps. Forty-two patients who had undergone 46 endoscopic DCR at a tertiary medical center, from 2002 to 2004, for correction of lacrimal system obstruction were investigated. The surgical technique involves elevation of a nasal mucosal flap, full sac exposure using a power drill, and shaping of the mucosal flap to cover denuded bone and juxtapose exposed sac mucosa. Postoperative symptoms and endoscopic findings of the neo-ostium were evaluated. Mean duration of follow-up was 5.9 months. An eighty-three percent primary success rate was observed, without any serious complications. Obstruction of the neo-ostium with granulation tissue was observed in eight cases, among which six underwent revision with success in all cases. Overall, 44 (96%) of 46 cases experienced surgical successes. Endoscopic DCR, a procedure in which a large marsupialized lacrimal sac is created from mucosal flaps, yields a very satisfactory success rate with straightforward and highly successful revision available for those in whom the primary procedure yields a substandard result.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Hospital, Dongjak-gu, Seoul, Korea. hrjin@paran.com
authors.forename: Hong-Ryul
authors.initials: HR
authors.lastname: Jin
authors.forename: Je-Yeob
authors.initials: JY
authors.lastname: Yeon
authors.forename: Mi-Young
authors.initials: MY
authors.lastname: Choi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007765:Lacrimal Apparatus / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000601:surgery; D013524:Surgical Flaps; D016896:Treatment Outcome