Endoscopic Endonasal Dacryocystorhinostomy Using an Otologic Drill: Bridging the Gap Between Objective Measures and Patient-Reported Outcomes

Year 2025, Volume: 8 Issue: 3, 97 - 104, 23.12.2025

Utku Kubilay , Süleyman Emre Cılız , Mürşit Alperen Yakut , Ozlem Yagiz Agayarov , İbrahim Çukurova

https://doi.org/10.65396/ejra.1828800

https://izlik.org/JA94TP58GU

Abstract

Objective: Dacryocystorhinostomy (DCR) bypasses an obstructed tear duct, allowing tears to drain directly into the nasal cavity. Although external and endonasal DCR approaches are effective, no universally accepted technique exists. This retrospective study evaluated the efficacy of endoscopic endonasal dacryocystorhinostomy (EnDCR) performed using an otologic drill, assessed by the nasolacrimal lavage test and the Lac-Q questionnaire.
Materials and Methods: We retrospectively analysed 20 eyes from 18 patients who underwent EnDCR between April 2021 and December 2022. Pre- and postoperative assessments included endoscopic examination, nasolacrimal lavage testing and Lac-Q scoring at ≥6 months follow-up.
Results: Patients were 4 males (22.2%) and 14 females (77.8%) with a median age of 63 years. Surgery was successful in 16 eyes (80.0%) and unsuccessful in 4 eyes (20.0%). Postoperative Lac-Q scores improved significantly in the successful group, whereas complications and revision surgery were more frequent in the unsuccessful group. Symptom severity and social impact scores were strongly correlated in patients with unsuccessful outcomes.
Conclusion: EnDCR using an otologic drill achieved a high success rate. The Lac-Q questionnaire provided valuable insight beyond the nasolacrimal lavage test, underscoring the importance of incorporating patient-reported outcomes in evaluating surgical success.

Keywords

dacryocystorhinostomy , endoscopic endonasal surgery , quality of life , Lac-Q questionnaire , otologic drill , nasolacrimal duct obstruction , epiphora

Ethical Statement

This study strictly followed the principles outlined in the Declaration of Helsinki. Ethical approval was obtained from Health Sciences University Tepecik Research and Training Hospital ethics committee (Meeting date: 2023, Decision No: 03-04).

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