title: Nasal endoscopic assessment of failure after external dacryocystorhinostomy.
abstract: OBJECTIVE
  To study intranasal causes of failure of external dacryocystorhinostomy (DCR).
  
  
  METHODS
  A retrospective study of clinical data from transnasal endoscopic findings after failure of external DCR.
  
  
  METHODS
  Assessment of 65 patients with failure after external dacryocystorhinostomy; subjectively by patient's symptoms and saccharine test and objectively by patency on syringing, functional endoscopic dye test and endonasal endoscopic assessment.
  
  
  RESULTS
  Endoscopic findings revealed: 20 cases intranasal adhesions, 8 cases septal deviation and concha bullosa, 8 cases abnormal size fistula, 6 cases rhinosinusitis, 6 cases contact granuloma, 3 cases of pouch, 4 cases closed ostium, 10 cases no definite cause could be found (functional failure). Negative dye clearance test and non-detection of fluorescein on irrigatiom in 55 patients. Delayed dye clearance but detection of fluorescein on irrigation in 10 patients (functional failure).
  
  
  CONCLUSIONS
  Nasal endoscopy is very important in diagnosing causes of failure of external DCR. Nasal endoscopy is essential before and after external DCR. DCR should be done by a team work of rhinologist and ophthalmologist. Study of mucociliary clearance of lacrimal pathway will help to improve our surgeries and whether to do small or large fenestra technique.
authors.affiliation: ENT Department, Masoura University, Mansoura. shawky_morsy2003@yahoo.com
authors.forename: Shawky Mahmoud
authors.initials: SM
authors.lastname: Elmorsy
authors.forename: Hytham Mohamed
authors.initials: HM
authors.lastname: Fayk
mesh_terms: D015331:Cohort Studies; D003608:Dacryocystorhinostomy / Q000009:adverse effects* / Q000379:methods; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007767:Lacrimal Duct Obstruction / Q000175:diagnosis; D008297:Male; D009296:Nasal Cavity / Q000503:physiopathology; D009301:Nasolacrimal Duct / Q000503:physiopathology / Q000601:surgery; D011183:Postoperative Complications / Q000175:diagnosis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D017211:Treatment Failure