External Dacryocystorhinostomy: A Comparison Of Ultrasonic Bone Aspiration To High-Speed Drilling

Figures & data

Table 1 Baseline Patient Characteristics

Variable^a	(n=88)	(n=57)	p value
	UBA	Drill
Age (mean ± SD)	58.8 ± 24.2	55.7 ± 22.6	0.44^b
Sex
Male	27 (30.7)	20 (35.1)	0.80^c
Female	61 (69.3)	37 (64.9)
Race
White	83 (94.3)	51 (89.5)	0.53^c
Black	3 (3.4)	3 (5.3)
Other/Unknown	2 (2.3)	3 (5.3)
Laterality (n=173)
Left	58 (54.7)	36 (53.7)	0.90^‡c
Right	48 (45.3)	31 (46.3)
NLDO etiology
Congenital	5 (5.7)	3 (5.3)	0.61^c
Acquired	83 (94.3)	54 (94.7)
Follow-up time^d (mean ± SD)	2.5 ± 1.6	2.8 ± 1.2	0.31^b

Notes: ^aReported as number (%) unless otherwise specified. ^bStudent’s t-test. ^cPearson chi-squared or Fisher’s exact test. ^dReported in months.

Table 2 Risk Factors For Surgical Failure

Patient Risk Factors^a	(n=88)	(n=57)	p value
	UBA	Drill
None	55 (62.5)	28 (49.1)	0.19^c
Periocular surgery	12 (13.6)	5 (8.8)
Periocular trauma	10 (11.4)	11 (19.3)
Previous probing/stenting	6 (6.8)	5 (8.8)
Other
Sarcoidosis	1 (1.1)	1 (1.8)
GPA^b	1 (1.1)	1 (1.8)
Lymphoproliferative disease	0 (0)	1 (1.8)
Radioactive iodine treatment	2 (2.3)	5 (8.8)
Cicatricial pemphigoid	1 (1.1)	0 (0)

Notes: ^aReported as n (%). ^bGranulomatosis with polyangiitis. ^cPearson chi-squared test.

Figure 1 Surgical time. Box and whisker plot demonstrates a statistically significant reduction in operative time for patients treated with the UBA (38.9 mins) compared to the high-speed drill group (44.7 mins; p= 0.01).

Figure 2 Surgical outcomes.

Figure 3 Osteotomy. (A) A completed bony ostium (O) through the left lacrimal fossa performed with the ultrasonic bone aspirator. The nasal mucosa (M) remains intact given the UBA’s ability to cut bone while sparing underlying soft tissue. (B) A completed bony ostium (O) through the right lacrimal fossa performed with the high-speed electric drill with a diamond burr. The nasal mucosa (M) demonstrates a small tear (T), an uncommon but potential complication of high-speed drilling.