Posterior Lacrimal Sac Approach in Endoscopic Dacryocystorhinostomy

Lee, Kyung Chul; Kwon, Kee Hwan

Abstract

BACKGROUND AND OBJECTIVES
To introduce the endoscopic posterior lacrimal sac approach in dacryocystorhinostomy with its success rate and complications.
MATERIALS AND METHODS
Posterior sac approach was performed on 10 patients with nasolacrimal duct obstruction from March, 1996 to May, 1997. To compare the accessibility to the lacrimal sac of anterior and posterior approach, bone thickness was measured in the anterior and posterior portion of the maxillary line on computed tomography of paranasal sinuses. Microvascular density (MVD) of the anterior ethmoid sinus mucosa and lateral nasal wall mucosa was measured to compare the degree of intraoperative mucosal bleeding.
RESULTS
There was no intraoperative complications, and this technique led to complete relief of lacrimal obstruction in 9 patients (90%) with a follow up of 13 to 30 months. Bone thickness was significantly thinner in the posterior portion of the maxillary line (p<0.001). MVD was higher in the ethmoid sinus mucosa than in the lateral nasal wall mucosa, but it was not significant statistically (p>0.05).
CONCLUSION
Posterior lacrimal sac approach has many advantages such as better assessibility to the sac, saving the operation time, and high success rate. Therefore, attempted by those who are experienced in endoscopic techniques, posterior lacrimal sac approach appears to be useful procedure in the surgical treatment of nasolacrimal duct obstruction.