{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,6]],"date-time":"2026-03-06T11:41:07Z","timestamp":1772797267288,"version":"3.50.1"},"reference-count":11,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2010,3,1]],"date-time":"2010-03-01T00:00:00Z","timestamp":1267401600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2010,3]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Evaluation of four methods of endoscopic dacryocystorhinostomy (EDCR) for treating chronic dacryocystitis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>A total of 1450 patients underwent EDCR for epiphora, chronic dacryocystitis, and blocked nasolacrimal ducts. Relief from epiphora, dacryocystitis, and patency of the fistula for all four techniques was compared. A total of 292 patients underwent incision and drainage, 343 patients had grommets inserted, 258 had silastic lacrimal stents inserted, and 557 had the medial wall of the lacrimal sac (LS) removed. Parameters of success were 1) resolution of epiphora, 2) no further attacks of dacryocystitis, and 3) patency of the new fistula.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Sixty\u2010five percent failed the incision method, and 68 percent of the patients who underwent the grommet method failed. All 258 patients with lacrimal stents experienced success while the stent remained in situ. Ten patients required removal because the stents created corneal opacities. One required removal because of a foreign body granuloma at the punctum. Only eight (1.4%) patients with removal of the LS failed. On multivariate analysis, female sex (OR = 5.6) was found to be associated with a higher rate of failure. Incision and drainage (OR = 100.1) and grommet insertion (OR = 60.6) were associated with increased risk of failure. Removal of the medial wall of the LS (OR = 0.069) and findings of a clear sac (OR = 0.001) or mucus (OR = 0.204) were associated with success.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The best EDCR results are achieved by stenting or removal of the medial wall of the LS. In our experience, excision of the medial wall of the LS was as successful as insertion of silastic lacrimal intubation stents, without the disadvantage of causing corneal opacities.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2009.12.031","type":"journal-article","created":{"date-parts":[[2010,2,19]],"date-time":"2010-02-19T04:17:55Z","timestamp":1266553075000},"page":"389-393","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Experience with endoscopic dacryocystorhinostomy using four methods"],"prefix":"10.1002","volume":"142","author":[{"given":"Chris","family":"de Souza","sequence":"first","affiliation":[{"name":"ENT and Skull Base Surgery Tata Memorial Hospital Lilavati Hospital and Holy Family Hospital Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jayesh","family":"Nissar","sequence":"additional","affiliation":[{"name":"Ophthalmology, Gala Eye Hospital and Jain Health Center Mumbai India"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,3]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"1","article-title":"Comparison of external and endonasal dacryocystorhinostomy","volume":"20","author":"Feretis M","year":"2008","journal-title":"J Laryngol Otol"},{"key":"e_1_2_8_3_1","first-page":"1","article-title":"Endoscopic \u2018cold steel\u2019 versus laser dacryocystorhinostomy: completing the audit cycle","volume":"18","author":"Lester SE","year":"2007","journal-title":"J Laryngol Otol"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215107009024"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-007-0286-0"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100109405"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-199602000-00015"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215107009954"},{"key":"e_1_2_8_9_1","first-page":"164","article-title":"Endoscopic dacryocystorhinostomy with a T type ventilation tube","volume":"36","author":"Kiroglu AF","year":"2007","journal-title":"J Laryngol Otol"},{"key":"e_1_2_8_10_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480701283745"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002341-198903000-00007"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2008.22.3132"}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2009.12.031","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1016\/j.otohns.2009.12.031","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1016\/j.otohns.2009.12.031","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T09:03:14Z","timestamp":1760950994000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1016\/j.otohns.2009.12.031"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,3]]},"references-count":11,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2010,3]]}},"alternative-id":["10.1016\/j.otohns.2009.12.031"],"URL":"https:\/\/doi.org\/10.1016\/j.otohns.2009.12.031","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,3]]},"assertion":[{"value":"2008-09-15","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2009-12-14","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2010-03-01","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}