**11. Outcomes of surgery**

The result of surgery, no matter the technique, depends on the type of obstruction. In a study by Tsirbas and Wormald, 95% of anatomic obstructions and 81% of fuctional obstructions became asymptomatic. Although the rate of getting asymptomatic in functional obstructions is lower, still most of them state that their situation is improved.

In one of our studies, the success rate of endoscopic DCR with mechanical devices was 91.4% in 6 months followup and 88.5% in a year followup. Intraoperaive bleeding in 88.6% of patients was mild to moderate and epistaxis during the first three days after surgery was noted in 21% of patients which was mild. In 3% of patients, the intranasal bleeding was

In endonasal surgery, complications are greater with inexperienced surgeons. The complications of endoscopic DCR are similar to those for endoscopic sinus surgery. Excessive bleeding during surgery precludes visualization and accounts for major intraoperative complications such as blindness and cerebrospinal fluid leakage. If excessive bleeding is encountered in endoscopic surgery, the procedure must either be terminated or converted to an open DCR. Severe postoperative epistaxis occurs in less than 5% of cases. Bleeding usually occurs within one week of surgery and is caused by a branch of the sphenopalatine artery supplying the remnant of a partially resected middle turbinate.

Sometimes, during bone removal to uncover the lacrimal sac, orbital fat is exposed. This fat should not be disturbed, otherwise orbital contents such as blood vessels, nerves, and the

Nasal or orbital infection following DCR is rare. Nevertheless, perioperative antibiotics are

One of the most common causes of surgical failure for both endoscopic and external DCR is postoperative adhesions. These adhesions usually cause obstruction of the surgically created ostium. In order to decrease this complication, surgical trauma to the turbinate mucosa should be avoided and the anterior end of the turbinate should be resected so that it is not near the ostium. Correction of the deviated septum also reduces the likelihood of

The advantages of intranasal endoscopic DCR in comparison to classic external DCR are as

4. Identification of the sac and correct placement of the opening between the sac and the

5. Immediate correction of surgical mistakes such as immediate control of brisk epistaxis

The result of surgery, no matter the technique, depends on the type of obstruction. In a study by Tsirbas and Wormald, 95% of anatomic obstructions and 81% of fuctional obstructions became asymptomatic. Although the rate of getting asymptomatic in functional

In one of our studies, the success rate of endoscopic DCR with mechanical devices was 91.4% in 6 months followup and 88.5% in a year followup. Intraoperaive bleeding in 88.6% of patients was mild to moderate and epistaxis during the first three days after surgery was noted in 21% of patients which was mild. In 3% of patients, the intranasal bleeding was

medial rectus muscle would be injured.

administered to avoid this complication.

postoperative adhesion formation.

1. Providing better visualization.

6. Reduction of surgery time

**11. Outcomes of surgery** 

follows13:

nasal cavity

**10. Advantages of endoscopic DCR** 

2. Avoiding the external scar and damage to the angular vein.

after anterior ethmoidal artery trauma by its direct cauterization

obstructions is lower, still most of them state that their situation is improved.

7. Diagnosis and treatment of coexistent intranasal disturbances.

3. Preserving the normal function of lacrimal pump.

moderate. 18% of patients had moderate pain in the first three days and 6%of them had that much pain in days 4 to 7 13.
