The impact of nasal cavity anatomical abnormalities on the success of Laser-assisted Dacryocystorhinostomy (LDCR).

Abstract

<b>Introduction:</b> The minimally invasive procedure of Laser-assisted Dacryocystorhinostomy (LDCR) has gained importance in the treatment of nasolacrimal duct obstruction, offering a potential alternative to traditional external and endonasal methods. This is an important topic in otolaryngology practice, as it offers an alternative to traditional endoscopic surgery. Due to the close anatomical proximity of the nose and the eye, addressing it requires collaboration within a multidisciplinary team. <br><br><b>Aim:</b> This study aims to evaluate the surgical effectiveness and factors influencing clinical outcomes. Anatomical issues such as nasal septum deviation and the size of the created ostium were assessed. <br><br><b>Materials and methods:</b> A total of 42 patients were included in the study, undergoing surgery on 46 nasolacrimal ducts. Follow-up evaluations were conducted at least 6 months post-surgery. <br><br><b>Results:</b> Anatomic and functional success was achieved in 93.48% of the patients. In patients without septal deviation, there were 35 successful outcomes and 2 failures, compared to 18 successes and 1 failure in the group with septal deviation. The findings revealed no significant correlation between septal deviation and surgical success, indicating that other factors may be more influential. Patients with an average-sized ostium reported better clinical outcomes and fewer tearing symptoms, while those with a deviated septum experienced more intermittent tearing. The overall mean ostium width was 2.37 mm. <br><br><b>Conclusions:</b> LDCR proved effective with a significantly shorter surgical time, benefiting patients seeking a quick recovery. While factors like anatomical abnormalities and septal deviation were not statistically significant for surgical success, patients with anatomical disorders often reported slightly poorer functional outcomes. Analyzing etiological factors and ostium development will help refine surgical techniques and improve patient satisfaction.