title: Acute post-operative rhinosinusitis following endonasal dacryocystorhinostomy.
abstract: OBJECTIVE
  To investigate the incidence and risk factors for acute rhinosinusitis (ARS) following endoscopic dacryocystorhinostomy (EnDCR).
  
  
  METHODS
  Retrospective single-surgeon interventional case series, including 196 consecutive patients undergoing 203 endonasal DCR, with clinical and radiological evidence of nasolacrimal duct or common canalicular obstruction. Pre-operative lacrimal and sinonasal clinical assessment and imaging, intraoperative endoscopic video recording, and post-operative clinical and endoscopic findings were analysed for cases of ARS occurring within the first 4 weeks following DCR among patients with and without a past history of chronic rhinosinusitis (CRS). Surgical complications and outcomes at 12 months and management of ARS are reported.
  
  
  RESULTS
  Three patients (1.5%) developed ARS within the first 5 post-operative days, none of which had experienced peri-operative complications and all had a past history of CRS. The rate of CRS in this cohort of 196 patients was 10.2% (n=20), of which 15% (n=3) developed ARS, although none had symptoms of CRS at the time of surgery; one had undergone previous sinus surgery. Presenting symptoms of ARS included facial pain, tenderness over the affected sinus, and nasal discharge; all patients responded to oral antibiotic therapy.
  
  
  CONCLUSIONS
  The rate of ARS following EnDCR was 1.5%. In those with a prior history of CRS, it was 15% (P=0.009). ARS developed within the first post-operative week among patients with a past history of CRS, who were asymptomatic at the time of surgery, and responded to oral antibiotics. CRS may be a risk factor for the development of post-operative ARS.
authors.affiliation: Department of Ophthalmology and Visual Sciences, South Australian Institute of Ophthalmology, Royal Adelaide University, Adelaide, South Australia, Australia.
authors.forename: P N
authors.initials: PN
authors.lastname: Shams
authors.forename: D
authors.initials: D
authors.lastname: Selva
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D003608:Dacryocystorhinostomy / Q000009:adverse effects* / Q000379:methods; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D012220:Rhinitis / Q000453:epidemiology / Q000209:etiology; D012307:Risk Factors; D012852:Sinusitis / Q000453:epidemiology / Q000209:etiology; D014057:Tomography, X-Ray Computed