Epiphora Secondary to Blockage of the Lacrimal System: The Role of Endonasal Dacryocystorhinostomy

Stenosis of the lacrimal system may occur secondary to tumor, infection, trauma, and congenital etiologies. Attempts to remedy this problem often include irrigation and probing. However, if these fail, external or internal dacryocystorhinostomy (DCR) with or without stenting may be performed. The purpose of this article is to detail our experience with a microscopic endonasal approach to DCR utilized in 23 patients. This is a modification of an older accepted procedure which utilizes the modern techniques of endonasal sinus surgery. This approach has allowed for immediate restoration of drainage in 22 of 23 cases. In one case, the procedure was repeated because of restenosis at the level of the lacrimal sac, but ultimately successful drainage was obtained.