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Vol. 53. Issue 7.
Pages 463-468 (September 2002)
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Vol. 53. Issue 7.
Pages 463-468 (September 2002)
Dacriocistorrinostomía endoscópica: técnica modificada
Endoscopic dacryocystorhinostomy: Modified technique
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H. Massegur Solench*,, E. Trias Mis*, J.M. Ademà Alcover**
* Servicio ORL. Hospital sta. Caterina. Girona
** Servicio ORL. Hospital generalde catalunya. Barcelona
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Resumen

La dacriocistorrinostomía (DCR) es una técnica quirúrgica que ha tenido un gran auge entre los otorrinolaringólogos en los últimos tiempos por la mejora del abordaje endonasal con los endoscopios. Aunque los resultados referentes a permeabilidad de la vía lacrimal son similares con las diferentes técnicas empleadas, presentamos unas modificaciones en la técnica quirúrgica que contribuyen a una mejor recuperación postoperatoria de la mucosa, por su carácter más funcional y menos agresivo, y mejoran la relación coste-beneficio. Se comparan dos grupos de pacientes, el primero (96 DCR) realizando la osteotomía con escoplo y sin colgajo de saco lacrimal y el segundo (40 DCR) aplicando la modificación técnica utilizando la pinza de Smith-Kerrison para la osteotomía y creando un colgajo de la mucosa de la pared del saco lacrimal. Los resultados finales son comparables: 92,7% vs 87,5%. No hubo complicaciones mayores y, entre las menores, la más frecuente fue el hematoma palpebral postoperatorio en los casos en que hubo exposición de la grasa orbitaria (5 casos vs 7 casos).

Palabras clave:
Dacriocistorrinostomía endoscópica
Cirugía endoscópica nasosinusal
Abstract

Dacryocystorhinostomy (DCR) is a surgical technique which has been adopted by otolaryngologists in the last years, because of the improvement in the endonasal approach by means of endoscopes. Although the results with the different techniques regarding permeability of the lacrimal duct are similar, we present some modifications in the surgical technique which contribute to a better postoperatory mucosal recovery, due to its more functional and less aggressive nature, improving the cost-benefit ratio. Two groups are compared, the first one (96 DCR) performing osteotomies with a chisel, without doing lacrimal duct and mucosa flaps, the second one (40 DCR) applying the modified technique using Smith- Kerrison forceps to perform osteotomies and creating lacrimal duct and mucosa flaps. Final results referred to permeability are similar (92,7% vs 87,5%). No major complications were found, and the most common minor complication was postoperative eyelid hematoma in cases of orbital fat exposure (5 cases vs 7 cases).

Key words:
Endoscopic Dacryocystorhinostomy
Endoscopic surgery

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