Abstract

Purpose: To compare the effects “H” and “U” flap technique on surgical success in external dacryocystorhinostomy (DCR).

Method: This study included 50 eyes of 50 patients (36 women, 14 men) with the diagnosis of distal nasolacrimal duct obstruction. All cases underwent external dacryocystorhinostomy (DCR). The patients were divided into 2 groups according to their order of operation. The first 25 cases were included in Group 1 and the next 25 cases were included in Group 2. In the first group, "H" shaped incision was made in the sac and nasal mucosa then patients assigned to anterior and posterior flap anastomosis. In the second group only anterior flap was prepared by "U" shaped incision was made in the sac and nasal mucosa and the patients assigned to only anterior flap anastomosis. All surgical steps were performed in the same way in all cases, except for the flap technique. Silicone intubation was not performed in any patient.

Results: The mean ages were 42.7±14.3 (range: 18-60) and 44.2±13.4 (range: 22-65) in group 1 and 2, respectively. The mean follow-up period was 10.5±3.6 (range: 7-14 mo.) and 11.4±4.2 (range: 5-13 mo.) months in group 1 and 2, respectively. Lacrimal drainage pathway was open in twenty one patients (%84) in Group 1 and 25 patients (%100) in Group 2, at last post-operative examination and all preoperative complaints were disappeared.

Conclusion: The rate of surgical success may increase with U-flap technique in DCR surgery. Prepearing of large enough flaps is possible with this technique in the patients with small sacs as well as the patients with big sacs.

Key Words: External Dacryocystorhinostomy; Mucosal Flap Technique; U-Flap; H-Flap.