Incidence of Dacryocystorhinostomy (DCR) in France: A Nationwide Study over the 2010-2019 Period

ABSTRACT

Background

To assess the annual incidence, surgical technique preferred (i.e. external versus endonasal) and the characteristics of patients undergoing a Dacryocystorhinostomy (DCR) in France over a 10-year-period.

Methods

A national observational cohort study was conducted in France between January 2010 and December 2019. Data were collected from the national PMSI (Programme de Médicalisation des Sytèmes d’Information) database provided by the CNAM (Caisse Nationale de l’Assurance Maladie). All patients undergoing a DCR were included.

Results

Twenty-one thousand one hundred ninety-nine patients, with a mean age of 70.4 years, were included. A female predominance (78%) was noted. The mean annual number of DCRs was 2481 (2366–2633), corresponding to a mean incidence of 3.8 per 100,000 person-years. This number remained stable over the study period (p = .966). Of the 24,808 DCRs, external DCRs were more prevalent compared to endonasal procedures (70.8% vs. 29.2%, p = .0001). Six hundred and fifteen (2.5%) associated acts were performed intraoperatively, mainly during endonasal DCR (96.3%). A total of 10,857 (43.8%) silicone stents were placed intraoperatively. Bicanalicular silicone stenting was preferred over the monocanalicular stenting. All the regions performed more likely external DCR except the Île-de-France area where endonasal DCR was performed in 75.6% of procedures. DCRs were mainly performed by an ophthalmologist (80%).

Conclusion

The mean annual incidence of external and endonasal DCRs remained stable over the study period. Endonasal DCR was more likely performed by the otorhinolaryngologists, emphasizing the need to develop personalized endonasal training in the ophthalmology residency program.

KEYWORDS:

• Dacryocystorhinostomy
• incidence
• transcutaneous
• endonasal
• pando

Acknowledgments

the authors thank CNAM/DSES/DATA.D for their help to collect all the data.

Contributorship Statement

JC monitored data collection, drafted and revised the manuscript.

EF revised the manuscript.

SN revised the manuscript.

CG revised the manuscript.

JL revised the manuscript.

JD revised the manuscript.

SB analyzed the data, drafted and revised the manuscript.

AM monitored data collection, analyzed the data, drafted and revised the manuscript and wrote the statistical analysis plan.

Disclosure statement

None of the authors.

Additional information

Funding

this research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.