title: Primary Nonendoscopic Endonasal Versus Delayed External Dacryocystorhinostomy in Acute Dacryocystitis.
abstract: OBJECTIVE
  Conventional treatment for acute dacryocystitis consists of medical management followed by elective delayed external dacryocystorhinostomy (EXT-DCR). The purpose of this study was to compare the outcome after primary nonendoscopic endonasal dacryocystorhinostomy (NEN-DCR) versus conventional treatment in acute dacryocystitis.
  
  
  METHODS
  Retrospective chart analysis of all consecutive patients of acute dacryocystitis presenting between 2011 and 2015 was performed. Group A had patients who underwent primary NEN-DCR within 2 weeks of presentation. Group B comprised age- and gender-matched patients who received conventional treatment.
  
  
  RESULTS
  Forty-six patients were included with 23 patients in each group. Mean age (45.2 ± 14.7 vs. 47.5 ± 14 years) and gender distribution (women 17/23 in group A vs. 15/23 in group B) in both groups were comparable. Mean duration from presentation to surgery was 7.82 ± 4.65 days for group A versus 27.3 ± 12 days for group B (p = 0.00001, independent T test). Mean time for complete resolution of symptoms was 21.4 ± 6 days for group A versus 38.69 ± 15.8 for group B (p = 0.000014, independent T test). Mitomycin-C usage (0.04%; 17 vs. 14) and mean follow up of both groups (6.4 vs. 5.7 months) were comparable. While functional success was similar (20/23) in both, anatomical success was seen in 22/23 and 21/23 in groups A and B, respectively. Complications included disfiguring scar in 4, recurrent acute dacryocystitis in 3, and punctal ectropion in one patient in the EXT-DCR group.
  
  
  CONCLUSIONS
  Primary NEN-DCR leads to faster resolution facilitating earlier rehabilitation with comparable anatomical and functional outcomes compared with conventional delayed EXT-DCR in acute dacryocystitis.
authors: *Ophthalmic Plastic and Reconstructive Surgery Service, L.V. Prasad Eye Institute, Bhubaneswar; †Ophthalmic Plastic and Reconstructive Surgery Service, L.V. Prasad Eye Institute, Vijayawada; and ‡Ophthalmic Plastic and Reconstructive Surgery Service, L.V. Prasad Eye Institute, Vishakhapatnam, India.
authors: Saurabh
authors: S
authors: Jain
authors: Anasua
authors: A
authors: Ganguly
authors: Swati
authors: S
authors: Singh
authors: Samir
authors: S
authors: Mohapatra
authors: Devjyoti
authors: D
authors: Tripathy
authors: Suryasnata
authors: S
authors: Rath
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D003607:Dacryocystitis / Q000601:surgery*; D003608:Dacryocystorhinostomy / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009301:Nasolacrimal Duct / Q000601:surgery*; D009666:Nose; D012189:Retrospective Studies; D016896:Treatment Outcome; D055815:Young Adult