The role of larger osteotomy in long term success in external dacryocystorhinostomy

Summary 

Aim

This study aims to investigate whether it is possible to create a critical size bone defect in external dacryocystorhinostomy (DCR), and also at what size a defect can be considered as being critical for a successful surgical outcome.

Methods

Eighteen patients undergoing 19 external dacryocystorhinostomies, with the creation of wide osteotomies, were enrolled in this retrospective study. A 2×2cm bone defect, which was considered as the critical size, was created. The postoperative structure of the bone gap was evaluated by computed tomography in axial and coronal planes at least two years after surgery. Functional patency of the ostium was confirmed with irrigation and nasal endoscopic examination.

Results

Thirteen female (72.2%) and five male (27.8%) patients underwent DCR. The patients were aged between 18 and 72 years old (mean±S.D.: 45.3±13.9). The follow-up time was between 24 and 48 months (mean 30.4 months). The areas of the gaps were between 1.21 and 4cm² (mean±S.D.: 2.26±0.19).

Conclusion

The critical size bone defect (2×2cm) might prevent restenosis in long term follow ups.

Keywords: External dacryocystorhinostomy, Computed tomography, Imaging, Epiphora, Restenosis