Anterior Flaps Anastomosis in External Dacryocystorhinostomy

Purpose: To evaluate the outcome of the modified technique of external dacrycystorhinostomy with anterior flaps anastomosis only. Methods: This prospective study included 52 patients with lacrimal drainage system disorders who underwent the modified technique of external dacrycystorhinostomy with anterior flaps anastomosis only. In this modified procedure of external dacryocystorhinostomy, anastomosis of anterior flaps only was created by suturing anterior flaps of the lacrimal sac and nasal mucosa, whereas posterior flaps were excised. The success rate and potential complications were recorded during the follow-up period. Results: The mean age of the patients was 44.6±9.9 SD years, including 37 females and 15 males. Mean of follow up was 17.1±1.8 SD months. Intraoperative complications, hemorrhage occurred in 3 cases (5.8%) and laceration of the nasal mucosa in 2 cases (3.8%). The surgery was uneventful in 47 cases (90.4%). The postoperative complication was closure of the anastomosis that occurred in 2 cases (3.8%). The success rate was evaluated by lacrimal patency to irrigation and relief of epiphora. Fifty patients (96.2%) showed a patent lacrimal system to irrigation and relief of epiphora, 2 patients (3.8%) had recurrence of epiphora and not patent lacrimal system to irrigation. Conclusion: This modified technique of external dacryocystorhinostomy with anterior flaps anastomosis only simplifies the surgical procedure and is effective in the management of obstruction of lacrimal drainage system beyond the common canalicular opening. Although it is simpler, quicker and easier to master the surgical technique, external dacryocystorhinostomy with anterior flaps anastomosis only shows a success rate comparable with those found in traditional external dacryocystorhinostomy. Further studies with larger series of cases are necessary.