Endoscopic DCR (Dacrocystorhinostomy)
A dacrocystorhinostomy (DCR) is a procedure to treat excessive tear flow (medically called epiphora) occurring due to a blockage in the nasolacrimal duct.
Any blockage in the long path of the tears that travel from the opening in eyelids to lacrimal sac (between nose and eye) finally through the nasolacrimal duct (tear duct) and to the nasal cavity, can lead to excessive tear outflow. One common reason is a blocked nasolacrimal duct. A DCR procedure creates a direct opening from the lacrimal sac into the nasal cavity to create a direct drainage mechanism.
While this duct can get blocked due to several identifiable reasons such as trauma, previous surgery, tumour, or an inflammatory medical condition, it is difficult to identify the underlying cause most of the times.
The evaluation and management of a DCR procedure may involve both an ophthalmologist and an otolaryngologist.
Excessive tear flow (epiphora)
Why this surgery?
If the patient does not opt for this surgery it might increase the risk of eye infections and inflammation.
- The pain is nominal and controllable with mild prescription pain medications.
- Low infection risk (some surgeons prescribe post-surgery antibiotics to cover it) after surgery.
- Very important from the patient’s point of view, there is no facial scarring. So aesthetically too, this is a superior procedure.
Know more about Endoscopic DCR (Dacrocystorhinostomy) Surgery
- Before the surgery the patient will need to attend for a pre-operative assessment, which will include some blood tests and ECG to ensure if general health is good enough for surgery
- The patient will be admitted to the hospital on the day of the surgery.
- If the patient is on any blood-thinning medications such as aspirin, ibuprofen, omega 3 and/or vitamin E, they should stop their intake at least a week before the surgery.
- Mention beforehand if allergic to any drugs.
- Some bleeding is expected during the first week after surgery. Change the dressing as needed. If there is excessive bleeding, visit the doctor.
- Eye drops or ointment is prescribed for two weeks and also antibiotic tablets to take for 5 – 7 days to avoid infections. Some patients are also prescribed a nasal steroid spray twice a day.
- Do not blow or pick nose for one week after the operation.
- Sneeze with mouth open if possible.
- For discomfort use a painkiller that is normally taken for a headache.
- Avoid taking blood thinning medicines for at least ten days after surgery.
- Avoid exercise especially swimming for two weeks after surgery.
- Air travel is not advisable for at least seven days after surgery.
- The first clinic appointment is 7 – 10 days after surgery to remove the stitches if they have been used.
- The second appointment will be 6 – 8 weeks after surgery to remove the tubes.
- A final check is usually made six months after surgery.
The possible risks associated with an endoscopic DCR are as follows:
- Bleeding is minimal but in rare cases, it can be more.
- Scarring can occur inside the nose that can block the created opening to cause excessive tear outflow once again.
- In rarest of rare cases, orbital hematoma i.e. bleeding within the orbital cavity can occur, or an eye muscle injury can be sustained. Either can lead to vision loss or double vision.
Why Dr Rao’s ENT?
Best Success Rate -It has a success rate of 95%.
World Class Technology
- Storz Image 1 HD endoscope camera system (GERMANY)
The one chip endoscope cameras are used for nasal endoscopy.
With 1,920 x 1,080 resolution and progressive scan, the camera control unit (CCU) guarantees a lag-free image and natural colour reproduction.