Researchers conducted this study to compare the causes of failure between external and endoscopic DCR techniques to treat lacrimal obstruction.

The present study is a retrospective cohort study.

The study population consisted of 53 consecutive patients who underwent revision endoscopic DCR for lacrimal duct obstruction. Identified causes of previous DCR failure were compared between patients whose initial surgery was performed through an external versus an endoscopic approach.

Adhesions that involved the middle turbinate were an incredibly impactful cause of failure when the DCR was performed through an external versus the endoscopic approach. Septoplasty was more likely to be needed when the initial procedure was performed externally at the time of revision surgery. Surgical success rates for revision DCR were comparable between the groups, with a mean follow-up of 12.7 months.

The study concluded that DCR failure associated with intranasal adhesions was more likely to occur when the surgery was performed through an external rather than an endoscopic approach. Endoscopic instrumentation allowed for identification and correction of intranasal pathology at the time of DCR, including an enlarged middle turbinate or a deviated septum, which may improve surgical outcome.