Endonasal endoscopic scalpel-forceps dacryocystorhinostomy vs endocanalicular diode laser dacryocystorhinostomy.

Purpose. To compare the efficacy of endonasal endoscopic dacryocystorhinostomy and endocanalicular diode laser dacryocystorhinostomy. Materials and methods. A total of 126 dacryocystorhinostomies were performed in 111 patients with epiphora. In 55% of cases (69/126) we performed an endonasal endoscopic dacryocystorhinostomy and in 45% (57/126) we carried out an endocanalicular dacryocystorhinostomy using diode laser. The mean age at diagnosis was 63 years. The mean age was higher in the endocanalicular group than in the endonasal endoscopic group: 64 versus 62 years. There were 25 men (23%) and 86 women (77%). Results. Successful results were achieved in 73% of patients (92/126). In the endonasal endoscopic group, 83% of patients (57/69) were symptom free compared to 62% of patients (35/57) in the laser diode group. A bicanalicular nasal silicone tube was left in place for a mean of 2.32 months in the endoscopic endonasal group and for 2.82 months in the laser diode group (p=0.164). Median time of recurrence after removal of the tube was 3.56 months (range 0-9.6): 2.84 months in the laser diode group and 4.87 months in the endonasal endoscopic group (p=0.069). Conclusions. The endonasal endoscopic approach achieved better results for nasolacrimal obstruction than the endocanalicular laser diode technique.