title: Office-based endoscopic revision using a microdebrider for failed endoscopic dacryocystorhinostomy.
abstract: This article is to introduce office-based endoscopic revision surgery using a microdebrider for failed endoscopic dacryocystorhinostomy (EN-DCR). The authors conducted retrospective, non-comparative, interventional case series analysis of 27 eyes of 24 patients, treated by office-based revision EN-DCR using a microdebrider. After local anesthesia, anatomical failures (cicatrization, granuloma, synechia) after primary EN-DCR were treated with a microdebrider (Osseoduo 120, Bien-Air Surgery, Le Noirmont, Switzerland) in an office setting, and a bicanalicular silicone tube was placed. Anatomical improvement and functional relief of epiphora were evaluated at 6-months after revision. The causes of failed EN-DCR were rhinostomy site cicatrization (17/27, 63.0 %), granulomatous obstruction (7/27, 25.9 %) and synechial formation (3/27, 11.1 %). The anatomical success rate was 100 %, and 85.2 % cases achieved complete relief of epiphora. The surgery did not exceed 10 min in any case and no complications were observed. Office-based revision EN-DCR using a microdebrider provided prompt management of post-DCR epiphora. The portable nature and all-round ability of the microdebrider allowed office-based surgery, which offered advantage to work with the surgeon's own well-trained office staff. Office-based revision EN-DCR can be both time- and money-saving, and might be regarded the treatment of choice for failed EN-DCR.
authors.affiliation: Department of Ophthalmology, Dongguk University Gyeongju Hospital, 87 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do, 780-350, South Korea.
authors.forename: Jongyeop
authors.initials: J
authors.lastname: Park
authors.affiliation: Department of Ophthalmology, Dongguk University Gyeongju Hospital, 87 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do, 780-350, South Korea. ophho@hanmail.net.
authors.forename: Hochang
authors.initials: H
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000556:Ambulatory Surgical Procedures / Q000295:instrumentation* / Q000379:methods; D000772:Anesthesia, Local; D002921:Cicatrix / Q000209:etiology / Q000601:surgery; D003608:Dacryocystorhinostomy / Q000295:instrumentation* / Q000379:methods; D003646:Debridement / Q000295:instrumentation* / Q000379:methods; D004724:Endoscopy; D005260:Female; D006099:Granuloma / Q000209:etiology / Q000601:surgery; D006801:Humans; D007766:Lacrimal Apparatus Diseases / Q000601:surgery; D007767:Lacrimal Duct Obstruction / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D011183:Postoperative Complications; D012086:Reoperation; D012189:Retrospective Studies; D017211:Treatment Failure
keywords: Dacryocystorhinostomy; Office surgery; Surgical revision; Transanal endoscopic surgery