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This abstract is assigned to session BOG-SBO: Oogleden, traanwegen / Paupières, voies lacrymales

Title	Comparative study between endonasal and external dacryocystorhinostomy: endoscopic nasal evaluation
Abstract Nr.	113

Purpose	To evaluate the factors that are correlated with success or failure in endonasal and external dacryocystorhinostomy (DCR) . The general opinion suppose that the higher failure rate of endonasal DCR is due to a smaller ostium. The size of the ostium after external DCR has been studied with several methods. In the literature we could not find data abouth the size of the ostium after endonasal DCR.
Methods	Included were patients who underwent a DCR for nasolacrimal duct stenosis at the AMC in the period from June 1999 to June 2004. Patients were recalled at random for ophthalmic examination with irrigation of the lacrimal drainage system and an intranasal endoscopic examination. The size, place and functionality of the ostium and appearance of synechiae were noted.
Results	An endonasal endoscopic evaluation was made of 60 patients (32 patients after endonasal DCR and 28 after external DCR). Surgical success was achieved in 82% in the external and in 87% in the endonasal group. The mean area of the ostium was 21,64 mm² (0,73 -113 mm²) in the endonasal group and 21,29 mm² (1,57 – 94,2 mm²) in the external group, which was not significant different. Of the failure cases, 70% was due to closing of the ostium and synechiae formation. Synechiae were found in 53% after endonasal DCR and in 49 % after external DCR.
Conclusion	From the study results, we could not endorse the prevaling opinion that endonasal DCRs have smaller ostia with subsequent higher failure rates. The failures were mostly the result of fibrosis of the ostium and the presence of transnasal synechiae. These synechiae were found equally after endonasal and external DCR.

Author 1

Last name	VANDELANOTTE
Initials	S
Department	Orbital Centre, AMC
City	Amsterdam

Author 2

Last name	Saeed
Initials	P
Department	Orbital Centre, AMC
City	Amsterdam