Powered endoscopic dacryocystorhinostomy with selective stenting.
OBJECTIVE
To compare surgical outcomes of primary powered endoscopic dacryocystorhinostomy (DCR) with selective or routine silicone stenting in anatomic and functional nasolacrimal duct obstruction (NLDO).


METHODS
Prospective nonrandomized cohort study with historical control group.


METHODS
Thirty-one consecutive primary powered endoscopic DCR procedures with selective stenting were performed for anatomic or functional NLDO. No stenting was used unless a tight Rosenmuller valve was appreciated when probing nasolacrimal system during surgery. Nasolacrimal system irrigation, dacryocystography, and lacrimal scintigraphy were used for preoperative assessment. Success was defined as absence of symptoms and patent nasolacrimal system. Comparisons were made with a historical cohort of 31 consecutive primary powered endoscopic DCR procedures with routine stenting.


RESULTS
The overall success rate was 79% (49/62), with 96.3% (26/27) success for anatomic and 65.7% (23/35) for functional NLDO. Success rates for anatomic NLDO were 100% (8/8) with selective stenting and 94.7% (18/19) with routine stenting (P > .05). Success rates for functional NLDO were 60.9% (14/23) with selective stenting and 75% (9/12) with routine stenting (P > .05). In the selective stenting group, 2/8 of the anatomic obstructions and 8/23 of the functional obstructions required stents.


CONCLUSIONS
Our study suggests that there is no difference in surgical outcomes of primary powered endoscopic DCR with selective or routine stenting in both anatomic and functional NLDO. We advocate a selective stenting approach for primary endoscopic DCR, whereby stents are only inserted when a tight common canaliculus opening is found during surgery.
Callejas
Claudio A
CA
Otorhinolaryngology Department, Pontificia Universidad Católica de Chile, Santiago, Chile.
Tewfik
Marc A
MA
Wormald
Peter-John
PJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery; D011446:Prospective Studies; D012828:Silicones; D015607:Stents; D016896:Treatment Outcome
D012828:Silicones