title: Non-endoscopic endonasal dacryocystorhinostomy--technique, indications, and results.
abstract: OBJECTIVE
  To describe the technique of non-endoscopic endonasal dacryocystorhinostomy (NEN-DCR), and its indications and results.
  
  
  METHODS
  In a prospective, non-randomized interventional case series, all consecutive cases presenting with epiphora between 2004 and 2006 were enrolled. Adult patients were divided into three subgroups: chronic nasolacrimal duct obstruction (NLDO), NLDO with dacryocystitis (NLDO-DC), and recurrent NLDO with previous failed external DCR (REV-DCR). All procedures were performed by one surgeon (first author). An endonasal DCR was performed through a nasal speculum without the use of an endoscope. Success was measured by both improvement of the epiphora and patency of the lacrimal system during irrigation.
  
  
  RESULTS
  Ninety-five patients (24 men, 71 women) underwent 99 NENDCR procedures; 54% of cases had NLDO, 32% had NLDO-DC, and 14% were REV-DCR. Mean duration of surgery was 30 minutes, and the average amount of intraoperative bleeding was 12 ml. After a minimum follow-up of 6 months, success was achieved in 96% of all patients, 94% in the NLDO group, 97% in the NLDO-DC group, and 92% in the REV-DCR group. The failure rate was 4% overall. Two patients failed from the NLDO group, one patient from the NLDO-DC group, and one patient from the REV-DCR group. No significant late complications were detected.
  
  
  CONCLUSIONS
  The success rate of NEN-DCR compares favorably with external DCR. The technique is also useful in cases of NLDO-DC and DCR-REV.
authors.affiliation: Department of Ophthalmology, Khatam-al-anbia Eye Research Center, Mashhad University of Medical Sciences, Iran.
authors.forename: Mohammad Etezad
authors.initials: ME
authors.lastname: Razavi
authors.forename: Alireza
authors.initials: A
authors.lastname: Eslampoor
authors.forename: Morteza
authors.initials: M
authors.lastname: Noorollahian
authors.forename: Annie
authors.initials: A
authors.lastname: O'Donnell
authors.forename: Bijan
authors.initials: B
authors.lastname: Beigi
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D003607:Dacryocystitis / Q000601:surgery; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012008:Recurrence; D016896:Treatment Outcome