title: What is the role of partial middle turbinectomy in endocanalicular laser-assisted endonasal dacryocystorhinostomy?
abstract: BACKGROUND
  This study was designed to compare outcomes of endocanalicular laser-assisted endonasal dacryocystorhinostomy (DCR) with and without partial anterior middle turbinectomy.
  
  
  METHODS
  A prospective randomized comparative study was conducted on 91 subjects with primary acquired nasolacrimal duct obstruction, undergoing endocanalicular (ECL) procedures. Group 1 was composed of 44 (7 bilateral) patients undergoing ECL diode laser-assisted endonasal DCR without partial anterior middle turbinectomy and group 2 was composed of 47 (7 bilateral) patients undergoing partial anterior middle turbinectomy and ECL diode laser-assisted endonasal DCR. Follow-up period was 11.0 (6.0-14.5 months) months for group 1 and 9.2 (5.0-14.2 months) months for group 2. Functional success was defined as absence of epiphora and anatomic success was defined as ability to irrigate the lacrimal system. Anatomic and functional success at the 1st week, 3rd month, and final postoperative examinations of two groups were compared using chi-square tests.
  
  
  RESULTS
  Final anatomic successes were 39/51 (76%) cases for group 1 and 51/54 (94%) cases for group 2. Final functional successes were 36/51 (%71) patients in group 1 and 48/54 (88%) patients in group 2. Group 2 had higher success at the final examination and the difference was statistically significant.
  
  
  CONCLUSIONS
  We recommend partial anterior middle turbinectomy in all laser ECL laser-assisted endonasal DCR, but further studies with larger sample sizes are needed to strengthen our hypothesis.
authors.affiliation: Department of Ophthalmology, Eskisehir Osmangazi University Medical Faculty, Eskisehir, Turkey. hbasmak@ogu.edu.tr
authors.forename: Hikmet
authors.initials: H
authors.lastname: Basmak
authors.forename: Hamdi
authors.initials: H
authors.lastname: Cakli
authors.forename: Afsun
authors.initials: A
authors.lastname: Sahin
authors.forename: Huseyin
authors.initials: H
authors.lastname: Gursoy
authors.forename: Ahmet
authors.initials: A
authors.lastname: Ozer
authors.forename: Ertugrul
authors.initials: E
authors.lastname: Colak
mesh_terms: D000328:Adult; D000368:Aged; D003608:Dacryocystorhinostomy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007765:Lacrimal Apparatus / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D007766:Lacrimal Apparatus Diseases / Q000175:diagnosis / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D007834:Lasers / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000473:pathology / Q000601:surgery*; D011446:Prospective Studies; D020127:Recovery of Function; D014420:Turbinates / Q000473:pathology / Q000601:surgery*