Comparison of Surgical Outcome in Endoscopic Dacryocystorhinostomy with and without Silicon Stent Placement

摘要

Objective: The purpose of this study was to compare the long term surgical outcome in endonasal dacrycystorhinostomy (DCR) with and without silicon stent placement. Subjects and method: A retrospective comparative analysis of 129 patients who underwent primary endoscopic DCR with stenting (group A) or without stenting (group B) was done. Success was defined as grade 0 or grade 1 epiphora at minimum 6 months follow up and complete patency of the lacrimal drainage system confirmed by irrigation. Patients were followed up for mean 28 weeks, (range 6 months to 2 years). Stents were usually removed at about three to six months (mean 21 weeks). Results: Out of the 129 patients, 90 underwent silicon stent placement (group A) as against 39 patients in which DCR was done without stenting (group B). Out of 90 patients of group A, 84 ( 93.33% ) showed complete recovery of symptoms (epiphora grading 0-1) Out of 39 patients of group B 35( 92.30%) showed complete recovery of symptoms at six months follow up. Patients with stent placements showed a slightly higher rate of success as compared to patients without stenting (93.33%/ 92.30%). There was however no statistical difference in the success rate between group A and group B (p- 0.8086). Conclusion: Silicon intubation of the nasolacrimal duct may not contribute to the success of endonasal DCR. Other factors such as size of the rhinostomy and presence of infection also play an important role in success of endonasal DCR.