Brief Insight about Trans-Canalicular Laser-Assisted Endoscopic Dacryocystorhinostomy

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Heba Mohamed Mahmoud Hamdy, Mohammed Abdel Azziem Mohammad, Wael Fayez Nasr


Background: Dacryocystorhinostomy (DCR) means creation of anastomosis for direct communication between the lacrimal sac and the nasal cavity through a bony ostium. There are different surgical techniques available for DCR. These include external DCR, endomechanical laser DCR, endonasal laser DCR, and transcanalicular laser-assisted DCR. Diode laser-assisted DCR offers many and specific advantages over conventional DCR. Recently, minimally invasive techniques like transcanalicular laser-assisted endoscopic DCR have gained popularity. Currently, this procedure is performed with an incision-free technique that avoids visible scarring, requires shorter operating time, produces less bleeding, and is easier to learn than other DCR methods. Overall, the success rate of laser-assisted endoscopic DCR in relieving epiphora is reported to be between 60 and 90 percent. The procedure is usually performed in patients who are concerned about external scarring and want a minimally invasive procedure. Furthermore, it is advantageous for patients who have bleeding disorders or must remain on anticoagulation medication. It is contraindicated in patients who have lacrimal or nasal sinus neoplasia. Relative contraindications include dacryolithiasis, canalicular obstruction, and canaliculitis. In addition, caution is needed in patients with altered nasal anatomy. Imaging studies are recommended to evaluate such patients to determine the nasal bony anatomy prior to surgery in selected cases.

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