Long-term outcomes of powered endoscopic dacryocystorhinostomy in acute dacryocystitis.

OBJECTIVES/HYPOTHESIS Endoscopic dacryocystorhinostomy (DCR) is rapidly gaining recognition as a primary modality of management in acute dacryocystitis and lacrimal abscess. The purpose of the present study is to report long-term outcomes of powered endoscopic DCR in cases of acute dacryocystitis. STUDY DESIGN Prospective interventional case series. METHODS Twenty-one powered endoscopic DCRs were performed in 21 patients presenting with acute dacryocystitis. All cases were operated by a single surgeon (m.j.a.) using earlier published techniques. All lacrimal systems were intubated for 6 weeks. A minimum follow-up of 1 year after stent removal was considered for final analysis. Main outcome measures were the anatomical and functional success of the surgical procedure. RESULTS The mean age of patients at presentation was 31.8 years. A total of 14.3% (3/21) were pediatric patients with known history of persistent congenital nasolacrimal duct obstruction (CNLDO), and 9.5% (2/21) had a history of external DCR in the past. All patients received postoperative antibiotics. Additional procedures included distal canalicular trephination, septoplasty, and middle turbinoplasty in one patient each. All cases showed resolution of pain and swelling at 1 week follow-up. At the mean follow-up of 15.4 months, anatomical success was achieved in 85.7% of the patients (18/21), and functional success was achieved in 80.9% (17/21). CONCLUSION Powered endoscopic DCR is a useful modality in the management acute dacryocystitis, with good outcomes that are maintained over a long duration of time. LEVEL OF EVIDENCE 4. Laryngoscope, 126:551-553, 2016.