View 2019 Abstracts

To review the outcomes of dacryocystorhinostomy (DCR) in the paediatric population and the impact of changing practice from predominantly external DCR to endoscopic DCR in majority of this cohort.

A retrospective review of 27 cases of DCR in 17 paediatric patients at a single centre under the care of a single consultant oculoplastic surgeon. Success was defined as resolution of symptoms or a patent nasolacrimal system. The cases for endonasal DCR were jointly assessed and selected by the oculoplastic surgeon and rhinologist.

From a total of 27 procedures, 7 were external DCR (26%) and 20 were endonasal (74%). Almost half of all patients had asthma, eczema, or atopic eye disease in each group. The mean age was 9.65 (range 2 to 17) with a similar distribution in both groups. 7 of the cases were redo DCR’s, of which 6 were endonasal and 1 was external approach.
The overall success rate was 20 out of 27. 4 out of 7 for external DCR and 16 out of 20 (80%) for endonasal DCR. Though the endoscopic DCR’s achieved a superior success rate the difference was not statistically significant. (p = 0.235) Of the redo cases, 5 out of the 7 were successful. The final cumulative success rate was 89% (24/27).
For primary DCRs, the rate of success was 86% for the endonasal approach but this was not statistically significant to the results of the external approach. (p = 0.091)

Our results confirmed that primary endonasal DCR has at least an equivalent success rate to external DCR. It can be performed in most paediatric patients above the age of two as a primary treatment and is better tolerated by children due to no requirement for postoperative suture management and no scar.