title: Comparison of impact of four surgical methods on surgical outcomes in endoscopic dacryocystorhinostomy.
abstract: OBJECTIVE
  To evaluate differences in the surgical outcomes of endoscopic dacryocystorhinostomy (DCR) according to four different surgical methods.
  
  
  METHODS
  This retrospective study included 222 patients who underwent endoscopic DCR from 2011 to 2013. All patients were assigned to one of four groups according to instruments for incision of nasal mucosa and the formation of mucosal flap: group 1, a sickle knife with mucosal flap; group 2, a sickle knife without mucosal flap; group 3, electrocautery with mucosal flap; and group 4, electrocautery without mucosal flap. The follow up period was at least 6 months.
  
  
  RESULTS
  There were 33 eyes in group 1, 44 eyes in group 2, 49 eyes in group 3, and 97 eyes in group 4. There were no significant differences in success rate between groups (P = 0.878). Wound healing time was significantly different between groups (P < 0.001). In post hoc analysis, wound healing time was significantly shorter in group 1 and group 2 than in group 3 and group 4. The vertical ostium size and postsurgical complication were not significantly different between groups.
  
  
  CONCLUSIONS
  The use of cold instruments such as sickle knife may be more helpful and effective for shortening wound healing time rather than making mucosal flaps in endoscopic DCR.
authors.affiliation: Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, South Korea.
authors.forename: Hyun Cheol
authors.initials: HC
authors.lastname: Roh
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Sehyun
authors.initials: S
authors.lastname: Baek
authors.affiliation: Department of Ophthalmology, Korea University College of Medicine, Seoul, South Korea.
authors.forename: Hwa
authors.initials: H
authors.lastname: Lee
authors.affiliation: Department of Ophthalmology, Dongguk University Ilsan Hospital, Goyang, South Korea. Electronic address: mdjacob@dumc.or.kr.
authors.forename: Minwook
authors.initials: M
authors.lastname: Chang
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003608:Dacryocystorhinostomy / Q000379:methods*; D004564:Electrocoagulation / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery / Q000379:methods; D012189:Retrospective Studies; D013524:Surgical Flaps; D016896:Treatment Outcome; D014945:Wound Healing; D055815:Young Adult
keywords: Endoscopic dacryocystorhinostomy; Surgical method; Wound healing time