Abstract

Objective. Endoscopic dacryocystorhinostomy (endo-DCR) is becoming a workhorse in the management of distal lacrimal duct obstruction. It yields success rates comparable to external DCR, with the advantage of no external scars. However, it requires multidisciplinary expertise and many uncertainties in terms of proper indications, technique, and perioperative management still exist.
Methods. Systematic review of the literature in the last 5 years using PubMed and Google Scholar.
Results. A total of 66 articles were included. Many technical modifications and surgical refinements have been proposed, but a formal comparison of the various techniques is hampered by methodological heterogeneity. The use of local anaesthesia and perioperative adjunctive techniques to reduce the risk of restenosis are also gaining popularity even if the level of evidence remains weak.
Conclusions. Endo-DCR offers satisfactory clinical outcomes even though there are many grey areas that need to be addressed in future high-quality studies.

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Luca Giovanni Locatello - Department of Otorhinolaryngology, Academic Hospital “Santa Maria della Misericordia”, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy. LGL and ERDZ equally contributed to the present paper

Enrico Redolfi De Zan - Department of Medicine - Ophthalmology, University of Udine, Udine, Italy. LGL and ERDZ equally contributed to the present paper

Nicole Caiazza - Department of Otorhinolaryngology, Academic Hospital “Santa Maria della Misericordia”, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy

Anna Tarantini - Department of Medicine - Ophthalmology, University of Udine, Udine, Italy

Paolo Lanzetta - Department of Medicine - Ophthalmology, University of Udine, Udine, Italy; Istituto Europeo di Microchirurgia Oculare (IEMO), Udine and Milan, Italy; University of Udine, Department of Medicine (DAME), Udine, Italy

Cesare Miani - Department of Otorhinolaryngology, Academic Hospital “Santa Maria della Misericordia”, Azienda Sanitaria Universitaria Friuli Centrale, Udine, Italy; University of Udine, Department of Medicine (DAME), Udine, Italy. Corresponding author - cesare.miani@uniud.it

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Copyright (c) 2024 Società Italiana di Otorinolaringoiatria e chirurgia cervico facciale

How to Cite
Locatello, L. G., Redolfi De Zan, E., Caiazza, N., Tarantini, A., Lanzetta, P., & Miani, C. (2024). A critical update on endoscopic dacryocystorhinostomy. ACTA Otorhinolaryngologica Italica, 44(6). https://doi.org/10.14639/0392-100X-N2916
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