An endoscopic endonasal approach to dacryocystectomy.

ABSTRACT A 78-year-old woman with dementia presented with functional visual loss secondary to bilateral chronic purulent dacryocystitis. A right external dacryocystorhinostomy (DCR) under local anaesthesia and sedation (LAS) was performed which failed after one month. Wound care was problematic as the patient removed all dressings and picked at the incision resulting in dehiscence and wound infection. She then underwent bilateral dacryocystectomy (DCT) under LAS and cauterisation of the common canaliculus via an endoscopic endonasal approach. Post-operatively her symptoms fully resolved. An endoscopic approach to lacrimal sac excision may be feasible in selected cases where a skin incision may not be desirable.