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.