Authors :
Maha Hakimi; Benhoummad Othmane; Youssef Rochdi; Abdelaziz Raji
Volume/Issue :
Volume 6 - 2021, Issue 4 - April
Google Scholar :
http://bitly.ws/9nMw
Scribd :
https://bit.ly/3xVOxGY
Abstract :
Dacryocystorhinostomy is the procedure
that marsupializes the lacrimal sac into the ipsilateral
nasal cavity. This rather simple and biased definition does
not summarize the rather tremendous difficulty for the
surgeon to decide on the most effective surgical route to
carry it out. Two surgical techniques then merge together,
endonasal Dacryocystorhinostomy, a prerogative of the
ENT doctor, and external Dacryocystorhinostomy,
preferred by ophthalmologists. The aim of our study was
therefore mainly to answer this still relevant question:
Dacryocystorhinostomy by endonasal route versus by
external route, when? and why?
Cases: It is for this purpose that we have collected 52
cases of Dacryocystorhinostomy operated by endonasal
route in the ENT department of the University hospital of
Mohamed VI in the city of Marrakech in Morocco, these
patients were seen over a period of 5 years, from January
2013 to January 2018; we thus included all the patients
presenting with chronic lacrimation, a permeable lacrimal
sac judged by a positive bone contact and having
undergone exclusive endonasal surgery.
Results/Discussion: Our ultimate goal was, of course, to
demonstrate the functional and anatomical superiority of
the endonasal route, in the end it is quite correct to say
that it is a surgical technique which, unlike its
counterpart, lends itself quite readily to the ambulatory
surgery under local anesthesia, but not only, the
endonasal route is a surgery with little or no bleeding,
requiring a short recovery period and minimal morbidity.
It is also fairly localized with very little collateral damage.
It is also very aesthetic for patients since it is endonasal
and does not require a facial scar, which is quite
embarrassing for the patient. This is not all, since this
approach allows the treatment of a coexisting nasal sinus
pathology and the correction of anatomical nasal sinus
obstacles often responsible of failures of external
dacryocystorhinostomy. Despite its innumerable
advantages, it would be fair to enumerate its
disadvantages, although few in number, such as difficulty
in locating the inside of the lacrimal sac and the common
orifice or the fragility of the lacrimal mucosa which can
be injured, resulting in stenosis.
Conclusion: Endonasal dacryocystorhinostomy should be
a first-line surgical intervention, and not just, as some
consider it, a technique for surgical revision of a failure of
external dacryocystorhinostomy.
Keywords :
Dacryocystorhinostomy, Lacrymo-Nasal Duct,Middle Turbinate
Dacryocystorhinostomy is the procedure
that marsupializes the lacrimal sac into the ipsilateral
nasal cavity. This rather simple and biased definition does
not summarize the rather tremendous difficulty for the
surgeon to decide on the most effective surgical route to
carry it out. Two surgical techniques then merge together,
endonasal Dacryocystorhinostomy, a prerogative of the
ENT doctor, and external Dacryocystorhinostomy,
preferred by ophthalmologists. The aim of our study was
therefore mainly to answer this still relevant question:
Dacryocystorhinostomy by endonasal route versus by
external route, when? and why?
Cases: It is for this purpose that we have collected 52
cases of Dacryocystorhinostomy operated by endonasal
route in the ENT department of the University hospital of
Mohamed VI in the city of Marrakech in Morocco, these
patients were seen over a period of 5 years, from January
2013 to January 2018; we thus included all the patients
presenting with chronic lacrimation, a permeable lacrimal
sac judged by a positive bone contact and having
undergone exclusive endonasal surgery.
Results/Discussion: Our ultimate goal was, of course, to
demonstrate the functional and anatomical superiority of
the endonasal route, in the end it is quite correct to say
that it is a surgical technique which, unlike its
counterpart, lends itself quite readily to the ambulatory
surgery under local anesthesia, but not only, the
endonasal route is a surgery with little or no bleeding,
requiring a short recovery period and minimal morbidity.
It is also fairly localized with very little collateral damage.
It is also very aesthetic for patients since it is endonasal
and does not require a facial scar, which is quite
embarrassing for the patient. This is not all, since this
approach allows the treatment of a coexisting nasal sinus
pathology and the correction of anatomical nasal sinus
obstacles often responsible of failures of external
dacryocystorhinostomy. Despite its innumerable
advantages, it would be fair to enumerate its
disadvantages, although few in number, such as difficulty
in locating the inside of the lacrimal sac and the common
orifice or the fragility of the lacrimal mucosa which can
be injured, resulting in stenosis.
Conclusion: Endonasal dacryocystorhinostomy should be
a first-line surgical intervention, and not just, as some
consider it, a technique for surgical revision of a failure of
external dacryocystorhinostomy.
Keywords :
Dacryocystorhinostomy, Lacrymo-Nasal Duct,Middle Turbinate
