title: [Dacryocystorhinostomy (DCR) under local anesthesia].
abstract: BACKGROUND
  Dacryocystorhinostomy (DCR) is performed using an external or endoscopic endonasal approach under general anesthesia (GA) or under sedation. In our department these operations are performed mainly under local anesthesia (LA) without sedation.
  
  
  OBJECTIVE
  To examine the intraoperative and postoperative success rates of primary DCR under LA and GA using the external or endonasal approach.
  
  
  METHODS
  The study group of this retrospective research included all patients who underwent a primary DCR in our department in 2009-2012 due to an acquired nasolacrimal duct obstruction. The main outcome measure was postoperative success defined as complete or significant improvement in tearing and a patent ostium. Intraoperative success rate was defined as the ability to complete the operation under LA.
  
  
  RESULTS
  The study group included 139 patients. The success rate was 87.1% (121 patients). Success rates were similar for the external and endoscopic approaches (88.6% vs. 82.4%, respectively, p = 0.348). The success rate for surgeries performed under GA was higher than LA (96.7% vs. 84.9%, respectively, p = 0.019). The mean age of patients who were operated under GA was significantly younger than those under LA (43.6 vs. 65.7 years, respectively, p < 0.005). Conversion GA was only needed in 1 patient (0.7%).
  
  
  CONCLUSIONS
  Most DCR surgeries can be performed under LA without sedation. Success rates found in our study are comparable with previous publications, similar for external or endoscopic approaches, and better under GA than LA. This difference may be related to the age difference between the two groups.
authors: Oded
authors: O
authors: Sagiv
authors: Nachum
authors: N
authors: Rosen
authors: Avelet
authors: A
authors: Priel
authors: Mordechai
authors: M
authors: Rosner
authors: Guy J
authors: GJ
authors: Ben Simon
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000768:Anesthesia, General / Q000379:methods; D000772:Anesthesia, Local / Q000379:methods*; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome