title: Efficacy of endonasal dacryocystorhinostomy, using 'cold steel' instruments without stenting, in treatment of distal nasolacrimal duct obstruction.
abstract: OBJECTIVE
  To assess the efficacy of an endonasal dacryocystorhinostomy technique using conventional instruments, without the use of any adjunctive techniques.
  
  
  METHODS
  Prospective, non-randomised, cohort study.
  
  
  METHODS
  Patients diagnosed with nasolacrimal duct obstruction between January 2006 and December 2008 were included in the study. Seventy-eight endonasal dacryocystorhinostomies (primary or revision) were performed with conventional 'cold steel' instruments. The technique involved complete exposure and marsupialisation of the lacrimal sac. No adjunctive procedures were used. Success was defined as complete resolution of epiphora and a patent lacrimal system, evaluated by lacrimal irrigation and endoscopy, one year post-operatively.
  
  
  RESULTS
  Seventy-four of the 78 cases were symptom-free after a minimum follow up of 12 months, giving an overall success rate of 94.9 per cent. The success rates for primary and revision cases were 95.5 and 90.9 per cent, respectively.
  
  
  CONCLUSIONS
  Meticulous surgical technique can ensure high success rates with the use of conventional cold steel instruments, without the use of adjunctive procedures, making endonasal dacryocystorhinostomy a cost-effective, reliable procedure.
authors.affiliation: Department of Otorhinolaryngology, Sri Siddhartha Medical College Hospital and Research Center, Siddhartha University, Tumkur, Karnataka, India.
authors.forename: L
authors.initials: L
authors.lastname: Ananth
authors.forename: P
authors.initials: P
authors.lastname: Hosamani
authors.forename: G
authors.initials: G
authors.lastname: Chary
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003362:Cost-Benefit Analysis; D003608:Dacryocystorhinostomy / Q000191:economics / Q000295:instrumentation / Q000379:methods* / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009297:Nasal Mucosa / Q000601:surgery; D009301:Nasolacrimal Duct / Q000601:surgery*; D057605:Natural Orifice Endoscopic Surgery; D011446:Prospective Studies; D012086:Reoperation; D013232:Steel; D013524:Surgical Flaps; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D013232:Steel