# Restoring the Flow: Observational Outcomes of Endoscopic Endonasal Dacryocystorhinostomy in a Tertiary Care Institution

## TL;DR

This study shows that endoscopic endonasal dacryocystorhinostomy is a safe and effective treatment for chronic tear duct blockage, with high success rates and minimal complications.

## Contribution

The study provides observational outcomes of EE DCR in a tertiary care setting, focusing on anatomical and functional success and patient-reported outcomes.

## Key findings

- Anatomical patency was achieved in 96% of patients at six months.
- Subjective symptom resolution occurred in 98% of patients.
- Significant improvements in symptom and quality of life scores were observed (P < 0.001).

## Abstract

Introduction: Nasolacrimal duct obstruction is a clinical condition characterized by epiphora and both acute and chronic dacryocystitis. Endoscopic endonasal dacryocystorhinostomy (EE DCR) is the treatment of choice for chronic dacryocystitis. This study aimed to evaluate the anatomical and functional success, safety profile, and patient-reported outcomes of EE DCR in chronic dacryocystitis in a tertiary care center.

Method: A retrospective review of 50 patients who underwent EE DCR between January 2020 and January 2025 was conducted. Data on demographics, clinical presentation, surgical technique, postoperative outcomes, and complications were gathered. Symptomatic improvement was measured using the Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS), and quality of life was assessed using a validated questionnaire both preoperatively and postoperatively at six months. Statistical analysis was performed using IBM SPSS Statistics for Windows, Version 26 (Released 2019; IBM Corp., Armonk, New York).

Results: The mean age was 35.2 ± 13.3 years with a female predominance of 31 (62%). Epiphora was the chief complaint in 42 (84%) of cases. At six months, anatomical patency was achieved in 48 (96%), and subjective symptom resolution occurred in 49 (98%). Mean NLDO-SS and quality of life scores improved significantly (P < 0.001). Complications were reported in 6 patients (12%), including intraoperative hemorrhage in 2 (4%), postoperative adhesions in 2 (4%), and granulation tissue formation in 2 (4%). No vision-threatening events were recorded.

Conclusion: EE DCR demonstrates high anatomical and functional success with low complication rates, offering a minimally invasive and effective alternative to external DCR. The procedure yields substantial improvements in patient symptoms and quality of life. Further prospective studies with larger cohorts and longer follow-up periods are warranted to validate these findings.