Abstract

Background: Endoscopic dacryocystorhinostomy (DCR) gained wide acceptance, with a comperable success to external DCR. Removal of sufficient bone over the lacrimal sac
in endoscopic DCR is crucial in obtaining a permanent rhinostoma. Several different methods utilized to accomplish this goal.

Aims: To describe the technique using hammer-chisel endoscopically for removal of bone over the lacrimal sac. Advantages and shortcomings of this technique were
discussed in the light of literatüre.

Methods: Prospective evaluation of endoscopic hammer-chisel DCR performed on 56 eyes of 40 patients with chronic epiphora or dacryocystitis were evaluated (24 unilateral and 16 biiateral, 36 female and 4 maie). Hammer-chiesel endoscopic DCR technique included chiesel removal of the bone located over the lacrimal sac. Preoperative intra or postoperative findings and follow-up rewieved and discussed.

Results: Follow-up period was 6 to 48 months (mean, 22) postoperatively. Success rate of consecutive endoscopic hammer-chisel DCR was 87.7%. Intraoperatively, 8 cases showing miid mucosal haemorrhage which neither prevented a successful completLon of operatLon. Excellent patLent tolerance wLth mLnLmal morbLdLty and no major compiication was observed.

Conclusions: Endoscopic Hammer-chisel DCR is less traumatic and practical with minimal per and postoperative compiications. It requires minimal instrumentation and is an easy and fast technique.

Key words: Endoscopic, chiesel, dacryocystorhinostomy