TY - JOUR ID - 24234 TI - External Dacryocystorhinostomy; Success Rate and Causes of Failure in Endoscopic and Pathologic Evaluations JO - Iranian Journal of Pathology JA - IJP LA - en SN - 1735-5303 AU - Ghasemi, Hassan AU - Asghari Asl, Sajedeh AU - Yarmohammadi, Mohammad Ebrahim AU - Jafari, Farhd AU - Izadi, Pupak AD - Dept of Ophthalmology, Medical School, Shahed University, Tehran, Iran AD - Dept of Otolaryngology, Medical School, Shahed University, Tehran, Iran Y1 - 2017 PY - 2017 VL - 12 IS - 3 SP - 189 EP - 194 KW - Lacrimal sac KW - Nasolacrimal Duct KW - Epiphora KW - Dacryocystorhinostomy DO - 10.30699/ijp.2017.24234 N2 - Background and Objectives: External dacryocystorhinostomy (DCR) is the method of choice to treat nasolacrimal duct (NLD) obstruction and the other approaches are compared with it, with a failure rate of 4% to 13%. The current study aimed to assess the causes of failure in external DCR by postoperative endoscopic and pathological evaluation. Methods: The current retrospective cross sectional study followed-up113 patients with external DCR and silicone intubation for three months. Silicone tubes were removed after the third months. Failure was confirmed based on the clinical findings and irrigation test. Paranasal sinus computed tomography (CT) scanning, and endoscopic and pathological evaluations were performed in the failed cases. Results: Totally, 113 patients underwent external DCR. The patients included 71 females and 42 males. The mean age of the patients was 55.91 years; ranged from 18 to 86. Epiphora was the most common complaint before surgery (90.3%). Clinically, epiphora continued in 17 cases (15%), of which 94.11% had at least one sinus CT abnormality and 82.35% had at least one endoscopic abnormality. The most common endoscopic findings were deviated septum (70.6%), scar tissue (52.94%), concha bullosa (46.9%), septal adhesion (47.05%), enlarged middle turbinate (41.2%), and sump syndrome (11.7%). The failure was significantly associated with the chronicity of the initial symptoms (P-value=0.00). Pathologically, there were significant relationship amongst the failure rate, scar formation, and allergic rhinitis (P-values =0.00 and <0.05, respectively). Conclusion: Preoperative endonasal evaluation and consultation with an otolaryngologist can improve surgical outcomes and help to have a better conscious to intranasal abnormalities before external DCR surgery. UR - https://ijp.iranpath.org/article_24234.html L1 - https://ijp.iranpath.org/article_24234_2c54d03d7e6ae8adc7f8703734b0abda.pdf ER -