Dacryocystorhinostomy (DCR)

Definition of disease:

Lacrimal duct obstruction, which occurs in adults, is a condition in which people have constant tearing and discharge from the eyes. The exact cause of this disease is not known and there are various reasons for it. However, the important point is that in most of these people (more than 60% of cases), there are other anatomical and inflammatory problems of the nose, such as a deviated nasal septum, nasal polyps, sinusitis, or the close proximity of the most anterior air cell of the ethmoid sinus to the lacrimal duct, or other problems. Experience has shown that during lacrimal duct surgery, in which a new path for the drainage of tears into the nose (dacryocystorhinostomy) is created, if these problems are not resolved, the likelihood of lacrimal duct surgery failure is higher.

👈 Causes of the disease:

The cause of the disease is congenital in children and acquired in adults. This can occur following trauma to the face and eyes, sinus and nose surgery, or the use of certain medications. One of the important causes of tearing is incorrect Botox and fat injections and eyelid and eyebrow surgery without proper and prior examination of this area of the face, which leads to the eyelid not functioning properly in the tear drainage system. Another cause of tearing is eyelid inversion inward or outward, which can be a complication of inappropriate and unprincipled eyelid and eyebrow surgery.

👈 Symptoms of the disease:

Tearing is the main symptom in patients. Sometimes the accumulation of tears in the eye causes blurred vision and the patient is referred for this reason. Sometimes this blockage leads to infection and purulent and sticky discharge. Infection may cause skin protrusion in the area of the lacrimal sac on the inner side of the eyelid. Continuous tearing can also lead to damage to the eyelid skin and cause the eyelid to turn outward.

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👈 Surgical method:

In this procedure, a 10-15 mm incision is made on the side of the nose. A thin polyethylene tube is then placed inside the nose to ensure that the newly created duct remains open during the healing period. This tube does not help drain tears and is only placed to keep the new duct open. This tube is removed 6-12 weeks after the procedure. The incision made in this procedure heals very quickly and is rarely visible after complete healing. This incision requires several stitches, which are removed 7-14 days after the procedure.

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👈 Operation time: minutes

20%

👈 Postoperative care:

Avoid bending your head down and eating and drinking hot foods and liquids for up to a week after surgery, as failure to do so can lead to severe nosebleeds.
To prevent nosebleeds, apply a cold compress or even an ice pack to the surgical site for up to twenty-four hours after surgery. Since this surgery is usually accompanied by heavy bleeding during surgery and even for a day or two after surgery, eat well after surgery so that your body can replace and compensate for the blood and iron lost. If you experience a severe nosebleed after surgery, go to the emergency room of a hospital with ENT facilities. The stitches are removed one week after surgery, and the scar on the skin of the nose gradually fades within 3 months. There may be some tearing while the silicone tube is in the canal, which will resolve when the tube is removed. The silicone tube is removed 4 to 6 months after surgery in the office through the nose without the need for anesthesia or sedation. The success rate of treating lacrimal duct obstruction with open surgical resection (DCR) is about 95%.

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👈 Causes of the disease:

👈 Symptoms of the disease:

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👈 Surgical method:

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👈 Postoperative care:

👈 Tear duct resection (DCR) video:

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