Endoscopic endonasal dacryocystorhinostomy: results in 56 patients.

Fifty-six patients with a complete stenosis of the nasolacrimal duct were treated by endoscopically controlled intranasal dacryocystorhinostomy according to West. Forty-four patients had idiopathic stenosis and 12 had posttraumatic scarring. Revision surgery was done in 11 of these 56 cases (8 patients with a previous external Toti procedure, and 3 patients with previous endonasal surgery). Altogether, 95% of the patients were symptom-free (86%) or felt improved (9%) postoperatively. Surgical revision was successful in 82%. Of patients with an "idiopathic" stenosis, 84% were healed and an additional 11% were improved. The success rate in the 12 patients with posttraumatic stenosis was 92%. Endoscopic duct surgery is a highly successful procedure with a low complication rate, the worst complication being persistence of symptoms.