Surgical Outcome and Characteristic Factors Post Operative Recurrence after External Dacryocystorhinostomy in Sisaket Hospital between 2018-2020

Abstract

The study of Post External Dacryocystorhinostomy (DCR) outcome and factors of recurrent nasolacrimal duct obstruction (NLDO) among primary and Revision DCR patients at Sisaket hospital during 2018 - 2020. Factors such as age, sex, and duration of disease were identified. Nasal cavity conditions were observed after one week, one month, three months, and six months after operation and silicone tube removal. The outcome was recorded by patient self-report of lacrimation and flow of lacrimal irrigation. Data were collected from In-patient and Out-patients records, then analyzed by percentage. Prevalence of Nasolacrimal duct obstruction was higher among females (82.65%) aged 61-70 years old, in an agricultural occupation, and higher among those with Diabetes Mellitus and Hypertension. The most common symptoms are epiphora (76.50%), injected conjunctiva, pain (13.30%), and mucus discharge (8.20%). The doctor's duration of onset is 1-2 years among primary and Revision DCR. Enlarge lacrimal sac with pus, NLDO with mucoid reflux, soft stop at 8mm LU, 6 mm LL, and superior position of lacrimal sac bone anterior to lacrimal sac fossa was found to be a clinical risk of recurrent NLDO. Pathology outcomes were compatible with granulation tissue and Basal cell carcinoma nodular type. Among 98 patients, 91 patients were primary DCR. After external DCR, the success rate was 100 percent among 98 patients. After 1 week to 3 months of follow-up, there was no postoperative complication. After silicone tube removal 6 months, 100% was the normal flow of lacrimal irrigation. The outcome of post-external DCR also depended on the onset to doctor duration and individual anatomical factors (5.10%). External DCR provided low-cost operation with local anesthesia; however, postoperative scars were the postoperative concern. External DCR was not advised for young adults; therefore, Endoscopic transnasal DCR became an alternative for those groups.