A comparison of outcomes between nonlaser endoscopic endonasal and external dacryocystorhinostomy: single-center experience and a review of British trends

Abstract 

Objective

The purpose of this study was to evaluate outcomes between nonlaser endonasal endoscopic and external dacryocystorhinostomy (DCR) in a district general hospital in the United Kingdom.

Study design

We conducted retrospective case notes review and postal questionnaire.

Subjects and methods

Case notes of patients who had DCR from August 2003 to August 2007 were reviewed. All patients were sent a questionnaire that included a visual analogue scale (VAS).

Results

Seventy patients were identified (35 external, 35 endoscopic). At discharge, 94% of external DCR patients reported being asymptomatic or improved compared with 86% for endoscopic DCR. The average VAS score for external DCR was 8.9 compared with 7.5 for endoscopic DCR (z = 2.1, P < .05). The average VAS score for external DCR was consistently higher than endoscopic DCR up to 30 months of follow-up.

Conclusion

External DCR offers better outcomes than endoscopic DCR. Endoscopic DCR is associated with fewer reported complications. A postal questionnaire can be a good alternative method of assessing long-term outcomes rather than relying solely on protracted clinic follow-up. There are few published endoscopic DCR results from the UK, and formalized training must be introduced.