Factors Associated With Outcome of Endonasal Dacryocystorhinostomy

Purpose: To identify factors associated with outcome of endonasal dacryocystorhinostomy. Methods: One hundred thirty-four cases of endonasal dacryocystorhinostomy in 111 patients performed for primary acquired nasolacrimal duct obstruction by a single surgeon between March 12, 2002 and November 10, 2008 were included in a retrospective, noncomparative case series. Variables assessed during the surgery included intranasal view, difficulty of bone removal, size of the lacrimal sac, presence of lacrimal sac stones, orbital fat prolapse and degree of bleeding. Successful outcome was defined as patency to lacrimal irrigation at final follow up. Results: One hundred twenty-one of the 134 cases (90%) were patent to irrigation at final follow up (mean 8.8 +/- 8.6 months). A small lacrimal sac opening intraoperatively was associated with higher risk of failure (odds ratio [95% confidence interval] of 5.7 [1.6, 20] [p = 0.0072]). Orbital fat prolapse had a trend toward higher risk of failure that approached statistical significance (odds ratio [95% confidence interval] of 5.3 [0.87, 32] [p = 0.0698]). A narrow intranasal view, difficult bony opening, lacrimal sac stones, and bleeding were not associated with outcome. Conclusions: A small lacrimal sac opening intraoperatively was associated with failure of endonasal dacryocystorhinostomy.