Outcomes of endonasal dacryocystorhinostomy performed for functional obstruction confirmed on dacryoscintigraphy

Author Block: Kevin Hodgson , Bridgette Chan, Ahsen Hussain.  Dalhousie University.

Author Disclosure Block:  K. Hodgson:  None.  B. Chan:  None.  A. Hussain:  None.

Abstract Title: Outcomes of endonasal dacryocystorhinostomy performed for functional obstruction confirmed on dacryoscintigraphy

Abstract Body: Purpose:  To report the demographics and outcomes of endonasal dacryocystorhinostomy (DCR) performed for a series of patients with functional epiphora confirmed by dacryoscintigraphy (DSG).  Study Design:  Case series of endonasal DCR outcomes in patients with symptomatic epiphora with no evidence of lacrimal hypersecretion or lacrimal pump failure, ≥60% patency on syringing, and DSG-confirmed nasolacrimal obstruction. A successful outcome was defined as subjective improvement or resolution of tearing on the operated side.  Methods:  Patient charts, DSG results and operative records were examined and data collected. Descriptive statistics were used to report patient demographics and case outcomes. Relevant literature was reviewed and discussed.  Results:  We included 10 patients in this case series. The mean age was 61.7 years at the time of surgery. Half the patients had reduced patency to syringing. Most patients had post sac obstruction, retention or delay. One patient had pre and post sac retention. Six patients had success following endonasal DCR and one patient had failure. Three patients await surgery. Follow-up for all operated patients was over 6 months. There were no reported complications by the surgeon or patients.  Conclusions:  Patients with functional epiphora confirmed by DSG appear to have a high success rate following endonasal DCR. In patients with symptomatic epiphora with subjective patency on syringing, use of DSG in decision-making and outcome prediction may be supported. Further studies including clinic-based tests to demonstrate functional obstruction are warranted.