Muhammad Umar Farooq, Murtaza Ahsan Ansari, Shanila Feroz, Shuja Farrukh.
Management of Nasolacrimal duct Obstruction through Endoscopic Dacryocystorhinostomy in Patients with Compromised Nasal Airway.
Pak J Otolaryngol Jan ;29(2):43-6.

OBJECTIVE: To study the effects of endoscopic dacryocystorhinostomy in obstructed nasolacrimal duct in patients with compromised nasal airway. DESIGN: Quasi Experimental Study. PLACE & DURATION OF STUDY: The study was conducted at the department of ENT-Head & Neck Surgery, Dow University of Health Sciences, Karachi from September 2002 to September 2012. Patients were selected from different hospitals including Faiz-e-Aam Hospital, National Medical Centre, Mid City Hospital and Civil Hospital, Karachi. PATIENTS & METHODS: Clinical records of 82 patients, who were diagnosed to have nasolacrimal duct obstruction and managed by endoscopic approach, were reviewed. Patients were divided in two groups. Group ‘A’ comprised patients with normal nasal patency and Group ‘B’ with compromised nasal airway. Data was collected including age, gender, associated nasal pathologies, or concomitant nasal surgery performed, post-operative relief of epiphora and complications if any, were recorded. Patients were followed up for 3 to 9 months. Surgical success was defined by complete relief from epiphora and free drainage of nasolacrimal duct, after 6 and 9 months of follow up. RESULTS: A total of 82 surgeries were performed in this series. Mean age was 41 years, and 52.4% (n=43) were female. Associated nasal pathology was found in 30.5% (n=25/82) patients. The commonest nasal pathology encountered in this study, was deviated nasal septum which was found in 18.3% (n=15/82) cases. Post-operative nasal synechiae and subsequent failure from relief of epiphora was observed in 32% (n=8/25) patients with reduced nasal patency (Group B). In contrast, occurrence of post-operative nasal synechiae was rare 5.2% (n=3/57) cases in other patients where the nasal patency was adequate and not compromised (Group A). CONCLUSION: Nasal anatomical or pathological variations are very common which result in reduced nasal patency. Among different nasal conditions, septal deviation is the most common, followed by concha bullosa. These anomalies increase the chances of post-operative synechiae formation. It can be minimized if these nasal conditions are concomitantly corrected.

PakMediNet -Pakistan's largest Database of Pakistani Medical Journals - http://www.pakmedinet.com