Dacryocystorhinostomy

Dacryocystorhinostomy (DCR) is a surgical procedure that aims to eliminate fluid and mucus retention within the lacrimal sac, and to increase tear drainage for relief of epiphora (watering eyes). This procedure is generally performed when the nasolacrimal duct, which is responsible for the drainage of tears from the lacrimal sac into the nose, is obstructed.

Indications

DCR surgery is indicated in cases of nasolacrimal duct obstruction (NLDO), acute or chronic dacryocystitis, lacrimal sac mucocele, and lacrimal sac tumors. It is also performed in cases of failed nasolacrimal duct probing in children.

Procedure

The procedure involves creating a new pathway for tear flow from the lacrimal sac into the nasal cavity. This is achieved by removing a piece of bone from the nasal wall, allowing for direct communication between the lacrimal sac and the nasal cavity. The procedure can be performed externally or endoscopically.

Complications

Complications of DCR surgery include bleeding, infection, scarring, and failure of the procedure, leading to persistent symptoms. Other complications include injury to the medial canthal tendon, damage to the nasal mucosa, and cerebrospinal fluid leak.

Postoperative Care

Postoperative care includes regular nasal irrigation with saline solution, topical and systemic antibiotics, and nasal decongestants. Follow-up visits are necessary to monitor the healing process and to ensure the success of the procedure.

See Also

• Lacrimal apparatus
• Epiphora
• Nasolacrimal duct obstruction
• Dacryocystitis

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