Table 7.
Studies (1995–2010) reporting results of primary dacryocystorhinostomy, endoscopic endonasal and external
| Study | Number of surgeries | Endonasal success | External success | Complications | Follow up |
|---|---|---|---|---|---|
| Leong et al28 | 70 35 external 35 endoscopic |
86% | 94% | N = 11 | 30 months |
| Dolman5 | 354 201 endoscopic 153 external |
89.1% | 90.2% | Epistaxis n = 11 (endonasal) n = 7 (external) Bruising n = 2 (external) Local infection n = 4 (external) Punctal eversion n = 6 (external) Transient diplopia n = 1 (endonasal) |
|
| Sharma29 | 302 165 endonasal (nonendoscopic) 137 external |
88.5% 146 |
90.5% n = 124 |
Wound infection n = 4 (endonasal) Nasal mucosal fibrosis n = 8 Nasal hemorrhage n = 2 Canalicular cut by silastic tube n = 24 |
24 months |
| Ben Simon et al15 | 176 86 endoscopic 90 external |
84% | 70% | Sump syndrome n = 2 Postoperative hemorrhage n = 1 |
7.2 endonasal 6.7 external |
| Cokkeser et al21 | 130 51 endoscopic 79 external |
88.2% n = 45 |
89.8 n = 71 |
Intra and postoperative hemorrhage n = 0 (endonasal) n = 14 (external) Wound infection n = 4 (external) Poor wound healing n = 5 (external) |
2 months |
| Agarwal17 | 300 endoscopic | 94% n = 282 |
Lacrimal fisula n = 4 Granulations n = 2 |
NR | |
| Sonkhya and Mishra13 | 226 endoscopic | 92% | Ostium fibrosis 8% Orbital fat prolapse n = 2 Granuloma n = 7 Synechiae (nose) n = 3 |
6–24 months | |
| Smith et al23 | 9 endoscopic (patients on warfarin) | 78% n = 7 |
Common canaliculi obstruction n = 1 Adhesions (lateral nasal wall and middle turbinate) n = 1 Periorbital bruising n = 2 Postoperative hemorrhage n = 1 |
6 months | |
| Jin et al30 | 46 endoscopic | 96% N = 44 |
Obstruction secondary to granulation tissue or synechia n = 8 |
5.9 months | |
| Nussbaumer et al31 | 201 endoscopic | 90% n = 181 |
NR | 12 months | |
| Tsirbas and Wormald19 | 104 endoscopic | 89% n = 93 |
Postoperative hemorrhage n = 3 | 9.7 months | |
| Tsirbas and Wormald18 | 44 endoscopic | 91% n = 40 |
NR | 12.9 months | |
| Moore et al32 | 35 endoscopic | 83% | New canalicular obstruction n = 1 | 6 months | |
| Wormald20 | 47 endoscopic | 97.5% n = 46 |
Nil | ||
| Yung and Hardman-Lea3 | 191 endoscopic | 89% | NR | 6–12 months | |
| Zilelioglu et al33 | 64 endoscopic | 79.6% n = 51 |
Punctal laceration n = 2 Periorbital oedema n = 1 Tube complications n = 18 |
NR | |
| Fayet et al34 | 300 endoscopic | 87% n = 261 |
Postoperative hemorrhage n = 4 Transient frontal sinusitis n = 1 Nasal mucosa burn n = 1 Cacosmia n = 8 Phlebitis n = 1 Maxillary pain n = 8 |
13 months | |
| Onerci et al35 | 108 experienced endoscopic surgeon 55 inexperienced endoscopic surgeon |
94.5 % experience 58% inexperienced |
Granulation tissue around wound n = 6 No hemorrhage |
49 months | |
| Watters et al36 | 43 endoscopic | 86% | 1–46 months | ||
| Pandya et al37 | 338 external | 77.3% full resolution of symptoms 20.8% partial resolution |
NR | NR | 11 months |
| Delaney and Khooshabeh38 | 50 external | 70% overall n = 35 80% post sac and 47% presac |
NR | 36 months | |
| Tarbet and Custer2 | 93 external | 95% patency 92% Asymptomatic |
Poor scar formation n = 1 | ||
| Feretis et al39 | 131 90 external 41 endonasal Glasgow benefit inventory questionnaire |
+9.7 IQR (–22.08 to +43.7) |
+12.50 (IQR, 0.000 to +38.888) | NA | NA |
| Leong et al40 | 4800 (review of 73 studies) | 84%–94% Laser assisted = 47%–100% |
65%–100% | NR | |
| Maini et al41 | 126 60 endonasal laser 66 endonasal sugery |
68% laser group 74% surgical group |
N/A | Intra-operative: Obstruction caused by: prominent agger nasi cells n = 2, concha bullosa or large middle turbinate requiring incision n = 5, adhesions from previous surgery n = 2, deviated nasal septum requiring septoplasty n = 3, nasal polyps n = 2 Postoperatively: Postoperative bleeding n = 1 Pyocoele n = 1 Peri-orbital ecchymosis post local anesthetic n = 5 Vestibular abrasions n = 2 Three patients randomized to laser converted to surgical treatment due to technical difficulties Five patients randomized to laser underwent combined laser and dissection technique |
12 months |
Abbreviations: endoscopic, endoscopic endonasal dacryocystorhinostomy; IQR, interquartile range; NA, not applicable; NR, not recorded; RCT, randomized controlled trial.