Outcome of dacryocystectomy with nasal bone osteotomy for lost nasal flap dacryocystorhinostomy with repeated post-operative probing

Abstract

Aim: (1) To evaluate the effect of dacryocystectomy (DCT) with osteotomy on correction of epiphora in terms of subjective and objective assessment and (2) to compare the outcome of probing with non-probing in DCT with osteotomy. Materials and Methods: A prospective interventional study done on 36 patients with chronic dacryocystitis complaining of watering due to distal sac block or nasolacrimal duct block with intraoperative complications like significant bleeding when angular vessels are encountered, difficult in suturing flaps, or lost nasal flaps are subjected to the study from December 2015 to May 2017. DCT with nasal bone osteotomy done for these patients and they were followed up postoperatively on day 1, every week in the 1 st month, 2 weeks in the 2nd month, and once in the 3rd month with probing or without probing in randomly selected patients. Results: A total of 36 patients were subjected to DCT with nasal bone osteotomy among them 18 underwent for probing and 18 were not. Of 18 with probing patients, 4 (22%) were objectively corrected (no regurgitation on lacrimal syringing) and 8 (44%) were subjectively corrected (no complaints of watering). Of 18 non-probing patients, only 1 (5.5%) was corrected objectively and 2 (11%) were corrected subjectively. Conclusion: DCT with nasal bone osteotomy with probing is more effective when compared with non-probing in lost nasal flap dacryocystorhinostomy both in terms of subjective and objective correction of epiphora.