Endoscopic DCR with or without Stent in a Peripheral Tertiary Care Centre of West Bengal – Our Experience

BACKGROUND Dacryocystorhinostomy (DCR) operation is the gold standard treatment for management of chronic dacryocystitis due to nasolacrimal duct block. This operation directs the lacrimal flow into the nasal cavity creating an artificial opening made at the level of lacrimal bone, thus obtaining a low-pressure lacrimal bypass system which will relieve epiphora and dacryocystitis. But the commonest reason for failure of this surgery is closure of the rhinostomy (neo-ostium). To overcome this difficulty, silicone tube catheter stent insertion has been advocated. Here in this study, we wanted to compare the success rate of endoscopic DCR with or without silicone tube catheter (STC) stent. METHODS This study was a prospective study conducted among 50 patients divided in to two equal groups randomly. One group underwent Endoscopic DCR with silicone tube catheter stent and another group underwent DCR without stent. We compared outcomes of both groups subjectively with five-point scale and objectively examined patency of the stoma by syringing with water postoperatively after 3 months and results were compared. RESULTS During subjective evaluation, we used five-point scales to get the grade of epiphora relief. First three grades (grade 1 to grade 3) were considered as success. We got an overall success rate of 92 % in without stent group and we got 88 % success rate in silicone tube catheter stent group. CONCLUSIONS Surgical success for Endoscopic DCR surgery encompassed both anatomical patency and symptom relief. We found overall success rate of 92 % in without stent group and 88 % success rate in silicone tube catheter stent group which were closely comparable to other studies. We also found failure due to granulation tissue formation in STC stent group. So the role of stent is yet to be confirmed and further large scale trials are needed. KEYWORDS Endoscopic DCR, Silicone Tube Catheter (STC) Stent