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Abstract
External dacryocystorhinostomy (DCR) was originally described in 1904 by Toti and is considered the criterion standard of lacrimal bypass surgeries. Success rates greater than 90% are common with this technique, but disadvantages, such as skin incision and disruption of the medial canthal ligament causing dysfunction of the lacrimal pump, have led to the evolution of endonasal endoscopic DCR. Several studies have shown endoscopic DCR to have comparable surgical outcome to external DCR and thus, owing to its advantages of being cosmetically more appealing, and less hurtful to the lacrimal pump system, it appears that endoscopic DCR may become the gold standard of treating epiphora and/or dacryocystitis in the future. The anatomy of the lacrimal system, the surgical technique of endonasal endoscopic DCR and several important issues regarding endoscopic DCR, such as the use of mitomycin-C, the need for silicone intubation and a comparison between external and endoscopic DCR, will be discussed.
Financial & competing interests disclosure
The authors have no relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript. This includes employment, consultancies, honaoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.
No writing assistance was utilized in the production of this manuscript.