**1. Introduction**

48 Otolaryngology

It was found that the best results were achieved with removal of the medial wall allowing the LS to get marsupialized. Stenting the LS also provided good results but had the disadvantage of causing corneal opacities especially if the stent moved from its position**(5)**. Inserting grommets or incising and draining the LS gave poor results. Removal of the medial wall of the LS allowing it to fistulize into the nasal cavity was statistically more

6. Removal of the medial wall allowing the lacrimal sac to marsupialize into the nasal

7. Stenting is also effective but on occasion can cause corneal opacities especially when it

Feretis M, Newton JR, Ram B et al: Comparison of external and endonasal dacryocystorhinostomy. *Journal of Laryngology and Otology* 2008:20:1-5. Yigit O, Samancioglu M, Taskin U et al: External and endoscopic dacryocystorhinostomy in

Welsh MG, Katowitz JA: Timing of silastic tubing removal after intubation for congenital nasolacrimal duct obstruction. *Opthal Plastic Reconstr Surger.* 1989:5:43-48. De Souza CE, Nissar J: Experience with endoscopic dacryocystorhinostomy using four

Smirnov G, Tuomilehto H, TerasvirtaM et al; Silicone tubing is not necessary after primary

methods. *Otolaryngology- Head and Neck Surgery*2010:142:389-393.

chronic dacryocystitis; comparison of results. *European Archives of* 

endoscopic dacryocystorhinostomy: a prospective randomized study*.American* 

successful and was found to be statistically significant.

1. Endoscpic DCR is a safe and valid procedure 2. Results with endoscopic DCRs are excellent.

5. It is not associated with major complications.

cavity is the best way to ensure long term patency.

*Otorhinolaryngology* 2007: 264:879-885.

*Journal of Rhinology* 2008: 22: 214-217.

**5. Conclusions and summary** 

3. It can be revised easily. 4. It is cost effective

is loosened.

**6. References** 

Endoscopic DCR has gained a lot of attention among otolaryngologists since the outcomes are comparable to the external approach. Advances in surgical technique and a better understanding of the anatomy have resulted in improvement of outcomes.

The main goal of this chapter is to acquaint readers with the anatomy and function of lacrimal system, the newly emerged technique of endoscopic DCR and its related topics.

In this chapter, the anatomy of the lacrimal system will be discussed in detail. Then, the conditions needing surgical manipulation will be noted in addition to assessing the patients with such problems. Surgical indications and techniques of DCR will be explained. Some topics such as the advantages, results and complications of the surgery and the role of Mytomycin C are included, too.
