[Current recommendations of dacryocystorhinostomy].
CURRENT RECOMMENDATIONS OF DACRYOCYSTORHINOSTOMYOBJECTIVE: With the implementation and the development of endoscopic systems, especially in functional endoscopic sinus surgery (FESS) in the last two decades, the gold standard considered external dacryocystorhinistomy (DCR) by Toti in patients with an obstruction of the lacrimal sac or the nasolacrimal duct has been replaced more and more by endonasal techniques. The endonasal approach, first performed in 1893 by Caldwell and publiciced by West 1911, has been modified since than, reached increasing acceptance and is nowadays often performed be ENT surgeons and ophthalmologists.


METHODS
This review article presents the possible reasons of an obstruction of the lacrimal sac or the nasolacrimal duct with consecutive epiphora or recurrent dacryocystitis, describes diagnostic procedures and indications of therapy, and tries to demonstrate the surgical change towards endoscopic endonasal techniques. We compare both operation techniques and discuss their advantages with the focus on the endonasal approach. The relevance of additional adjuvants described in literatur (laser, use of mitomycin or fluoruracil or silicon intubation) are presented and discussed, too.


RESULTS
At the end we discuss the published results of both techniques (endonasal vs. external DCR) and compare their success rates. In spite of the tendency towards endonasal endoscopic techniques the results of this approach seem to be a little worse in comparison to the results after external DCR.
Meister
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EF
Klinik für Hals-, Nasen-, Ohrenheilkunde Klinikum St. Georg gGmbH, Delitzscher Strasse 141, 04129 Leipzig. HNO@sanktgeorg.de
Otto
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M
Rohrwacher
F
F
Mozet
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C
D003608:Dacryocystorhinostomy / Q000379:methods*; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis / Q000209:etiology; D014057:Tomography, X-Ray Computed