PURPOSE: To examine the appearance of the lacrimal passage using dacryoendoscopy in failed dacryocystorhinostomies, examining the relationship between the remnant lacrimal sac mucosa and the obstruction tissue, and to detect canalicular obstruction. METHODS: Twenty failed dacryocystorhinostomies (4 right and 16 left) in 19 Japanese patients (8 males and 11 females) aged 36 to 81 years (average, 69.5 years) were reviewed. Dacryoendoscopy was used to examine the lacrimal passage of the failed dacryocystorhinostomies. RESULTS: An occluded space was found with no adhesion between the remnant lacrimal sac mucosa and the fibrous obstruction tissue in every failed dacryocystorhinostomy. None of the lacrimal canaliculi or the common internal ostia was obstructed. CONCLUSIONS: A space without adhesion between the remnant lacrimal sac mucosa and the obstruction tissue was visualized in all the failed dacryocystorhinostomies. No canalicular stenosis was seen, including the common internal ostium, in this cases. Based on these results, endoscopic revision for failed dacryocystorhinostomies is a safe procedure, performed without orbital fat prolapse.
PURPOSE: To examine the appearance of the lacrimal passage using dacryoendoscopy in failed dacryocystorhinostomies, examining the relationship between the remnant lacrimal sac mucosa and the obstruction tissue, and to detect canalicular obstruction. METHODS: Twenty failed dacryocystorhinostomies (4 right and 16 left) in 19 Japanese patients (8 males and 11 females) aged 36 to 81 years (average, 69.5 years) were reviewed. Dacryoendoscopy was used to examine the lacrimal passage of the failed dacryocystorhinostomies. RESULTS: An occluded space was found with no adhesion between the remnant lacrimal sac mucosa and the fibrous obstruction tissue in every failed dacryocystorhinostomy. None of the lacrimal canaliculi or the common internal ostia was obstructed. CONCLUSIONS: A space without adhesion between the remnant lacrimal sac mucosa and the obstruction tissue was visualized in all the failed dacryocystorhinostomies. No canalicular stenosis was seen, including the common internal ostium, in this cases. Based on these results, endoscopic revision for failed dacryocystorhinostomies is a safe procedure, performed without orbital fat prolapse.