View 2019 Abstracts

To evaluate prevalence of post-operative epistaxis and pain in patients who underwent external or endoscopic dacryocystorhinostomy (DCR), in order to evaluate best pre-, intra- and post-operative practice.

Retrospective, single-centre, review of 54 cases between 2017-18 under the care of a single consultant. Data on anticoagulant use, epistaxis prevalence, pain score (0-10) and overall satisfaction (0-5) were surveyed by telephone for day of surgery (day 0) and afterwards (day 1+).

27 cases underwent external DCR, 5 were on anticoagulants; 27 underwent endoscopic DCR, 4 were on anticoagulants. There was no association between epistaxis and anticoagulant use. Overall, epistaxis prevalence on day 0 and day 1+ respectively was 13% and 9% for old blood, 15% and 13% for spotting, 7% and 2% for mild epistaxis. 2 patients had significant epistaxis after endo-DCR; one blew his nose soon after surgery, the other was on rivaroxaban and required re-admission. There was no significant difference in epistaxis prevalence between the groups. Pain scores on day 0 and day 1+ respectively were 1.1 and 0.9 for external DCR and 1.5 and 1.3 for endonasal DCR (no significant difference; p = 0.14 and 0.11). Analgesia use was 26% and 33% respectively (p = 0.28). Satisfaction scored 4.7 for external DCR; 4.5 for endonasal DCR (p = 0.21). Scores were 4.5 and 4.7 for those discharged on day 0 and day 1 respectively (p = 0.31).

We found no association between epistaxis and anticoagulant use, no difference in epistaxis between external and endonasal DCR, no difference in pain between external and endonasal DCR and neither DCR technique nor duration of hospital stay affected patient satisfaction.