title: Comparison of Modifications in Flap Anastomosis Patterns and Skin Incision Types for External Dacryocystorhinostomy: Anterior-Only Flap Anastomosis with W Skin Incision versus Anterior and Posterior Flap Anastomosis with Linear Skin Incision.
abstract: OBJECTIVE
  To compare the outcomes of external dacryocystorhinostomy (E-DCR) by using two different flap anastomosis patterns and skin incision types.
  
  
  METHODS
  This study included 79 patients (88 eyes) with lacrimal drainage system disorders who underwent E-DCR surgery. Fifty eyes of 44 patients (group A) underwent E-DCR by suturing anterior and posterior flaps (H-flap) of the lacrimal sac with curvilinear skin incision whereas in 38 eyes of 35 patients (group B) DCR was performed by suturing only anterior flaps (U-flap) with W skin incision.
  
  
  RESULTS
  The success rate was evaluated according to lacrimal patency and scar assessment scores. Patency was achieved in 78 patients (88.6%). In terms of groups, patency was 44 eyes (88.0%) in group A and 34 eyes (89.5%) in group B. There was no statistically significant difference in the success rates of lacrimal patency between the two groups. Further, there was no statistically significant difference concerning cutaneous scar scores.
  
  
  CONCLUSIONS
  Our study suggests that anastomoses of only anterior flaps or both anterior and posterior flaps have similar success rates; suturing only anterior flaps is easier to perform and shortens the operative time. In addition, W skin incision is a reasonable alternative to curvilinear incision for reducing scar formation.
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Burcu
authors.initials: B
authors.lastname: Dirim
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Selam Yekta
authors.initials: SY
authors.lastname: Sendul
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Mehmet
authors.initials: M
authors.lastname: Demir
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Erdem
authors.initials: E
authors.lastname: Ergen
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Zeynep
authors.initials: Z
authors.lastname: Acar
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Ali
authors.initials: A
authors.lastname: Olgun
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Semra
authors.initials: S
authors.lastname: Tiryaki
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Hakan
authors.initials: H
authors.lastname: Sensoz
authors.affiliation: Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey.
authors.forename: Dilek
authors.initials: D
authors.lastname: Guven
mesh_terms: D000714:Anastomosis, Surgical; D002921:Cicatrix / Q000473:pathology; D003608:Dacryocystorhinostomy / Q000379:methods*; D003710:Demography; D062109:Dermatologic Surgical Procedures / Q000379:methods*; D004322:Drainage; D005260:Female; D006801:Humans; D008297:Male; D009301:Nasolacrimal Duct / Q000601:surgery; D012867:Skin / Q000473:pathology*; D013524:Surgical Flaps