{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T14:40:25Z","timestamp":1787841625794,"version":"build-2784847793"},"reference-count":25,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T00:00:00Z","timestamp":1787270400000},"content-version":"vor","delay-in-days":20,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,8,1]],"date-time":"2026-08-01T00:00:00Z","timestamp":1785542400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>Endoscopic dacryocystorhinostomy (DCR) is a well\u2010established surgical procedure used to restore lacrimal drainage in patients with nasolacrimal duct obstruction. Various instrumentation techniques have been used for lacrimal bone osteotomy; however, their comparative effectiveness remains debated. This study aimed to evaluate surgical outcomes of endoscopic DCR performed using four different instrumentation techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective comparative cohort study included 360 consecutive endoscopic DCR procedures performed on 312 adult patients between 1995 and 2024 in a tertiary care center. All surgeries were performed by a single surgeon. Osteotomy was performed using a drill, microdebrider, Kerrison punch, or thulium:YAG laser. Surgical success was defined as resolution of symptoms and confirmation of a patent neo\u2010ostium on follow\u2010up. Comparative statistical analysis was performed to evaluate differences in success rates among techniques.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The overall success rate was 95.3%. Success rates were comparable across all instrumentation techniques, with no statistically significant difference observed between groups (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.99). Minor postoperative complications occurred in 2.8% of procedures.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Endoscopic DCR demonstrated high success rates across all instrumentation modalities. Surgical outcome appears to depend more on surgical technique and experience than on the specific instrument used for osteotomy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70548","type":"journal-article","created":{"date-parts":[[2026,8,22]],"date-time":"2026-08-22T04:20:51Z","timestamp":1787372451000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Osteotomy Techniques in Endoscopic Dacryocystorhinostomy: A Three\u2010Decade Comparative Cohort Study"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9642-649X","authenticated-orcid":false,"given":"Karl","family":"El Mendelek","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Saint George Hospital University Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amjad","family":"Damaj","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Saint George Hospital University Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jihad","family":"El Khoury","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Saint George Hospital University Medical Center  Beirut Lebanon"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,21]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.disamonth.2020.101043"},{"key":"e_1_2_11_3_1","volume-title":"StatPearls","author":"Perez 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