title: Endoscopic dacryocystorhinostomy in acute dacryocystitis: a multicenter case series.
abstract: OBJECTIVE
  To present our experience of early endonasal DCR (endoDCR) in the treatment of acute dacryocystitis (AD). Methods. International multicenter non-comparative retrospective study.
  
  
  RESULTS
  Eighteen patients were identified. All were treated with antibiotics prior to surgery with a median of time from referral to endoDCR surgeon to surgery of 3 days (range 1-7). Surgery was performed using mechanical powered endoDCR (MENDCR) in 15/18 (83.3%) cases; mitomycin C was used in 5/18 (27.8%) and all cases underwent bicanalicular intubation. An increase in perioperative bleeding was noted in 5/18 (27.8%), causing interference in surgical technique in one (5.6%). Resolution of AD was seen in all cases, with no recurrences. 17/18 (94.4%) cases were free of epiphora at median follow-up of 12 months (range 2-36), with nasal endoscopy revealing free flow of fluorescein through the ostium in 17/18 (94.4%) of cases. The median total length of stay was 1 night (range 0-3).
  
  
  CONCLUSIONS
  EndoDCR surgery performed early in AD led to rapid resolution of the condition in all cases and was associated with subsequent anatomical and functional success in 94.4% of cases. Early endoDCR surgery in the context of AD and the potential associated health economic benefits are worth further consideration and study.
authors.affiliation: Discipline of Ophthalmology & Visual Sciences, University of Adelaide, South Australia, Australia. drsimonmadge@gmail.com
authors.forename: Simon N
authors.initials: SN
authors.lastname: Madge
authors.forename: WengOnn
authors.initials: W
authors.lastname: Chan
authors.forename: Raman
authors.initials: R
authors.lastname: Malhotra
authors.forename: Raf
authors.initials: R
authors.lastname: Ghabrial
authors.forename: Stephen
authors.initials: S
authors.lastname: Floreani
authors.forename: Peter J
authors.initials: PJ
authors.lastname: Wormald
authors.forename: Angelo
authors.initials: A
authors.lastname: Tsirbas
authors.forename: Dinesh
authors.initials: D
authors.lastname: Selva
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003607:Dacryocystitis / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000379:methods*; D004724:Endoscopy / Q000379:methods*; D005260:Female; D006801:Humans; D007431:Intraoperative Complications; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents