ENDOSCOPIC DCR

Endoscopic Dacryocystorhinostomy (DCR) is a surgical intervention, performed to treat patients diagnosed with lacrimal sac or nasolacrimal duct obstruction (NLDO) which is either congenital or acquired. It is performed to restore the flow of tears into the nose from the lacrimal sac in case of nasolacrimal duct dysfunction.

Obstruction of nasolacrimal ducts lead to conditions called epiphora and dacryocystitis. Epiphora is the term commonly used to describe a watery eye caused by excessive secretion of tears due to obstruction of the lacrimal passages or the nasolacrimal duct. Dacryocystitis is an infection of the tear sac (lacrimal sac), secondary to obstruction of the nasolacrimal duct.

DCR is a minimally invasive procedure performed by ophthalmologists and otorhinolaryngologists to clear the tear ducts and correct the causes of decreased patency of the nasal passages. Generally, endoscopic DCR is considered for patients who are refractory to the conventional treatments like warm compresses, massage and probing of the nasolacrimal duct.

Endoscopic DCR Procedure

The procedure is performed under local anaesthesia. A decongestant is administered to clear the nasal passage first, followed by insertion of a gauze soaked in anaesthesia to numb the area.

Initially, an endoscope is inserted into the nasal cavity to the lacrimal sac through the lacrimal duct to identify and confirm the nature of the obstruction. Once the obstruction is identified, the nasal mucous membrane is incised and removed, to allow for the creation of a window on the lacrimal sac and upper nasolacrimal duct.

A portion of the lacrimal and maxilla bone is removed and a vertical incision is made in the lacrimal sac and nasolacrimal duct using a blade. Silicone tubes can be inserted to aid long-term potency of the nasal passages.

Complications Associated With Endo-DCR

Complications may arise in the following cases:

• Adhesions may form if care is not taken to protect the mucosa of the nasal septum and middle turbinate.
• If the tubes are tied too tightly, an adhesion can form at the medial canthus between the upper and lower puncta, and may require difficult oculoplastic corrective surgery.
• If the tubes are tied too tightly in the nasal cavity the knots can cause granulation tissue at the neo-ostium.
• Restenosis may also occur as late stage complication.

Post-Operative Care:

• Patients are discharged within a few hours.
• Five day course of decongestant nasal drops are prescribed post-operatively.
• Antibiotic eye drops should be applied for 2 weeks
• The nose should be irrigated with saline
• Post-operative visit after 2 weeks is suggested to clean the nose, remove crusts and to remove early adhesion
• Silastic tubes are removed in the office after 4 - 6 weeks

Advantages Of Endo-DCR therapy

It provides best results without any external scar and corrects the associated nasal pathology. The healing is smooth.

Why Choose BSR?

BSR ENT Hospital is a renowned ENT (ear, nose, and throat) hospital located in Hyderabad and Secunderabad with full-time otolaryngologists. BSR staffs the best ENT surgeons in Hyderabad like Dr. B. Shanker Rao, MS, DLO, FICS and Dr. B. Kalyan Chakravarthy, MS ENT / Head and Neck Surgeon, who are highly qualified with extensive knowledge and 35+ years of experience in problems related to ENT.

Our ENT specialists provide personalized care and use the latest technology in treatments for best treatment outcomes. At BSR, we work very closely with each of our patients to ensure that the proper diagnosis is established through comprehensive examinations.