A Critical Update on Endoscopic Dacryocystorhinostomy| ACTA Otorhinolaryngologica Italica

Abstract

Abstract

Objective: Endoscopic dacryocystorhinostomy (endo-DCR) is becoming a workhorse operation in the management of distal lacrimal duct obstruction. It yields success rates comparable to external DCR, with the advantage of no external scars. However, it requires multidisciplinary expertise but many uncertainties in terms of proper indications, technique, and perioperative management still exist.

Methods: Systematic review of the literature in the last 5 years by using PubMed and Google Scholar.

Results: A total of 66 articles were included. Many technical modifications and surgical refinements have been proposed but a formal comparison among the various techniques is hampered by methodological heterogeneity. The use of local anesthesia and perioperative adjunctive techniques to reduce the risk of restenosis are also gaining popularity but the level of evidence remains weak.

Conclusion: Endo-DCR offers satisfactory clinical outcomes even though there are many gray areas that need to be addressed in future high-quality studies.