Abstract
We have created an easy light guide method performed by an otolaryngologist for endoscopic dacryocystorhinostomy （En-DCR）, namely, extraductal transillumination （EDTI）, from the medial canthus. We evaluated whether EDTI could be an alternative method instead of the conventional intraductal light guide in primary En-DCR. This paper examines its efficacy in primary En-DCR.
Eight patients （1 man, 7 women）, involving 11 eyes including 8 cases of acquired nasolacrimal duct obstruction and 3 cases of chronic dacryocystitis, were enrolled in the preliminary study of the efficacy of EDTI. We investigated whether adequate bone removal of lacrimal fossa and full exposure of lacrimal sac were achieved or not under EDTI intraoperatively. Thereafter, primary En-DCR without stenting under EDTI was performed by an otolaryngologist for 9 patients （2 men, 7 women）, involving 12 eyes including 9 cases of nasolacrimal duct obstruction, and 3 cases of chronic dacryocystitis, to validate our preliminary study.
Adequate bone removal of the frontal process of maxillary bone over the internal common punctum was achieved in all the eyes under EDTI in the preliminary study. The result of primary En-DCR without stenting under EDTI by an otolaryngologist showed an anatomical success rate of 100％ and functional success rate of 91.7％, with a mean duration of 6 months of follow-up. No adverse effects associated with EDTI were observed.
EDTI is a comparable light guide method in primary En-DCR with the intraductal light guide installed by an ophthalmologist. Primary En-DCR without stenting under EDTI which can be done by an otolaryngologist for saccal and postsaccal obstruction has high anatomical and functional success rates.
