International Surgery Journal | February 2020 | Vol 7 | Issue 2 Page 440 International Surgery Journal Vishwani A et al. Int Surg J. 2020 Feb;7(2):440-446 http://www.ijsurgery.com pISSN 2349-3305 | eISSN 2349-2902 Original Research Article Study of patient outcome in endoscopic dacrocystorhinosomy using a microdebrider in chronic dacryocystitis patients Ankit Vishwani 1 *, H. C. Taneja 1 , G. K. Das 2 , Neelima Gupta 1 , Vipin Arora 1 INTRODUCTION Acquired dacryocystitis can be acute or chronic. 1 Chronic dacryocystitis is the inflammation of lacrimal sac, frequently caused by bacteria. Chronic being more common than acute. Dacryocystorhinostomy (DCR) is a surgery done for chronic dacryocystitis, with symptomatic distal obstruction of Nasolacrimal Duct (NLD). It is a bypass surgery in which obliterated NLD is bypassed and the lacrimal sac is directly opened into nasal cavity. Dacryocystorhinostomy is contraindicated too young (less than 4 years) or too old (more than 60 years) patient, markedly shrunken or fibrosed sac, tuberculosis, syphilis, leprosy or mycotic infections, tumors of sac or atrophic rhinitis. DCR can be performed by following methods: External approach, Endonasal approach, with or without laser, Laser assisted trans canalicular approach or user image guided navigation system. During the past 2 decades, endoscopic DCR (EN-DCR) has become accepted as a suitable treatment for patients with obstructions of the ABSTRACT Background: Endoscopic dacryocystorhinostomy (DCR) has become accepted as a suitable treatment for patients with chronic dacryocystitis. In this study authors did endoscopic dacrocystorhinosomy using a microdebrider, which is a recent advancement tool being used successfully in other endoscopic sinus surgeries also. Limited studies are available as of now on this topic. Methods: A total number of 33 patients (with 40 affected eyes) presenting with complains of epiphora having nasolacrimal duct obstruction were selected. They underwent an endoscopic DCR in which dissection of some nasal mucosa and widening of bony ostium was done using a microdebrider. Silicone stent was passed into the nasolacrimal duct through both punctum. Patient outcome was assessed by using both objective (endoscopy and dye test) and subjective (improved symptoms) criteria. Standard follow up time for clinical course was kept 3 months with weekly visits. Results: Patients which got relief from epiphora in 37 eyes (92.5% cases) had no obstruction on endoscopy and positive dye test. Rest (7.5 % cases) had presence of granulation tissue at rhinostoma site and negative dye test, which was cited as the cause of failure. Conclusions: The use of microdebrider is potentially beneficial in endoscopic endonasal dacryocystorhinostomy. By using such an instrument, the minimal amount of tissue damage occurs, a large fistula is formed, and the recurrence due to the formation of adhesions/synechiae/granulations is prevented/reduced thus reducing the time of surgery, complications and failure rate. Keywords: Chronic dacryocystitis, Dacrocystorhinostomy, Microdebrider, Nasolacrimal duct, Rhinostoma 1 Department of ENT, 2 Department of Ophthalmology, UCMS and GTB hospital, New Delhi, India Received: 25 November 2019 Revised: 02 January 2020 Accepted: 03 January 2020 *Correspondence: Dr. Ankit Vishwani, E-mail: ankit.vishwani@gmail.com Copyright: © the author(s), publisher and licensee Medip Academy. This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. DOI: http://dx.doi.org/10.18203/2349-2902.isj20200294