1Höft S., 2Holland D., 2Höft U., 1Maune S.

1Department of Otorhinolaryngology, Head and Neck Surgery, University Clinics Kiel, Arnold-Heller-Str. 14, 24105 Kiel, Germany; 2Department of Ophthalmology, University Clinics Kiel, Hegewischstr. 2, Kiel, Germany

Objective: Therapy of lacrimal duct obstruction has been changed with the introduction of the endonasal sinus surgery. We are presenting retrospective results of endonasal dacryocystorhinostomy over a period of 10 years.
Methods: On 217 patients (139 female, 78 male) 240 uni- or bilateral endonasal dacryocystorhinostomies with lacrimal duct intubation were performed from November 1989 until December 1999. Clinical follow-up was at least 6 months. Patient-data were analyzed regarding cause of complaints, extent and localization of lacrimal duct obstruction, duration of lacrimal duct intubation, and therapeutic outcome.
Results: Follow-up was on average 46 months (minimum: 6, maximum: 131). 72.1% of the patients were postoperatively free of epiphora. In 7.9% of the patients epiphora was improved, whereas in 20.0% epiphora was unchanged. Cause and extent of obstruction had no influence on the therapeutic result. A presaccal stenosis as well as an intubation of the lacrimal duct for less than 6 months were correlated with an increased risk of a recurrence of 29,2% and 33,3% respectively. Therapeutic complications were an abscess of the lower lid in one patient and a synechia between lower and upper lid in another patient.
Conclusion: Endonasal dacryocystorhinostomy with lacrimal duct intubation is a successful therapy of lacrimal duct obstruction with little complications. In patients with presaccal obstructions a lacrimal duct tube should be kept in situ for a long time to prevent a recurrence.

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