Dacryocystorhinostomy – Drill technique


Mário Ramalho, Inês Coutinho, Catarina Pedrosa, Susana Pina, Fernando Vaz, Mara Ferreira, João Cabral

     Introduction: Dacryocystorhinostomy or DCR is a bypass procedure with an anastomosis between the lacrimal sac and the nasal mucosa via a bony ostium. It may be performed through an external skin incision or intranasally with or without endoscopic visualization. The success rates for endoscopic and external dacryocystorhinostomy vary widely (external 70-95%; endonasal 59-99%).
     Video: In the “classic” Dupuy-Dutemps-Brouget technique a scalpel blade is used to perform the skin incision and a Citelli’s punch is used to perform an osteotomy. In our procedure we use an electric scalpel to perform the skin incision which is an arciform incision at the orbital rim and a high speed rotary drill to perform the osteotomy. This technique is the procedure of choice in our Hospital. In 54 consecutive procedures with at least 1 year of follow-up there were only 2 recurrences, with an overall success rate of 96.3%.
     Conclusion: DCR is today a surgery which is carried out with excellent results by the ophthalmologist as well as by the otorhinolaryngologist. Our procedure has some differences from the common approach which may help to raise the success rate.


no 32nd European Society of Ophthalmic Plastic and Reconstructive Surgery Annual Meeting, em Barcelona, Setembro de 2013