Endoscopic endonasal dacryocystorhinostomy combined with canaliculus repair for the management of dacryocystitis with canalicular obstruction

Purpose. the aim of this study is to propose a simple and efficient combination surgery for the management of dacryocystitis with canalicular obstruction. methods. a retrospective noncomparative case series of dacryocystitis with canalicular obstruction has been studied. twelve patients with dacryocystitis and canalicular obstruction underwent a conventional endoscopic endonasal dacryocystorhinostomy (ee-dcr) combined with a modified canalicular repair. postoperative observations included slit lamp,fluorescein dye disappearance test,lacrimal syringing,lacrimal endoscopy,and nasal endoscopy. results. after 6-18 months of postoperative follow-up,the symptoms of epiphora and mucopurulent discharge disappeared completely in 10 patients,and occasional or intermittent epiphora remained in 2 patients. all of the twelve patients showed an opened intranasal ostium and normal fluorescein dye disappearance test. patent bicanalicular irrigation was achieved in 9 patients. one patient had a partial and the other two had a complete reobstruction by lacrimal irrigation to their repaired lower canaliculus; however,all of them had a patent lacrimal irrigation to upper canaliculus. the functional success rate for the combination surgery is 83% (10/12),and anatomical success rate is 75% (9/12). conclusion. ee-dcr combined with modified canalicular repair is a simple and efficient method for the management of dacryocystitis with canalicular obstruction. © 2015 yunhai tu et al.