Korean J Otorhinolaryngol-Head Neck Surg.  2017 Oct;60(10):481-490. 10.3342/kjorl-hns.2017.00745.

Management of Nasolacrimal Duct Obstruction: ENT Surgeon's Perspective

• Chung YJ

• KMID: 2393811
• DOI: http://doi.org/10.3342/kjorl-hns.2017.00745

Abstract

Epiphora is an overflow of tears onto the face and mainly occurs secondary to abnormal excretory system such as nasolacrimal duct obstruction (NLDO), which could be congenital or acquired. In past years, patients with NLDO have been usually managed by ophthalmologists using external dacryocystorhinostomy (EX-DCR) which has been considered the gold standard of treatment. Recently, the advancement of nasal endoscope and endoscopic sinus surgery has contributed to perform endoscopic DCR (EN-DCR), which now offers comparable success rate to EX-DCR with many advantages. ENT surgeons are familiar with intranasal anatomy and nasal endoscope handling rather than ophthalmologists. Therefore, these advantages lead to more ENT surgeons performing endoscopic DCR. However, the learning curves exist to reach a favorable success rate because surgical technique should be delicate in the narrow nasal cavity. This paper attempts to describe management of epiphora from ENT perspective, focus on surgical anatomy, evaluation modalities and update on endoscopic technique and surgical outcome compared with EX-DCR. This present review would serve as a guide for beginners and increase their confidence with endoscopic anatomy and correct management of epiphora including EN-DCR procedures.

Keyword

Dacryocystorhinostomy; Endoscopy; Epiphora; Otolaryngology

MeSH Terms

Dacryocystorhinostomy
Endoscopes
Endoscopy
Humans
Lacrimal Apparatus Diseases
Learning Curve
Nasal Cavity
Nasolacrimal Duct*
Otolaryngology
Surgeons
Tears