Optimizing Endo-DCR Outcomes in Traumatic Nasolacrimal Duct Obstruction

Purpose: We evaluated the clinical value of computed tomography dacryocystography with multiplanar reconstruction (CT-DCG-MPR) in assisting endoscopic dacryocystorhinostomy (Endo-DCR) for traumatic nasolacrimal duct obstruction (NLDO). Patients and Methods: We retrospectively analyzed 16 patients (18 eyes) with traumatic NLDO who were treated between April 2019 and November 2021. All patients underwent CT-DCG-MPR and Endo-DCR. Patient demographics, fracture patterns, and surgical outcomes were analyzed. Results: The cohort had a mean age of 41.2 +/- 12.3 years, and 62.5% were male. Traffic accidents were the predominant injury mechanism (81.3%). Naso-orbito-ethmoidal (NOE) fractures were the most common type. CT-DCG-MPR showed a 94.7% correlation with intraoperative findings. Endo-DCR achieved 94.4% anatomical success and 88.9% functional success, with significant symptom improvement (p < 0.001). Conclusion: The lacrimal sac-nasolacrimal duct junction was the most frequent site of obstruction or fracture in traumatic NLDO. CT-DCG-MPR-guided Endo-DCR is highly effective for traumatic NLDO, providing precise preoperative planning and excellent long-term outcomes.