{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T12:02:00Z","timestamp":1784635320619,"version":"3.55.0"},"reference-count":36,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T00:00:00Z","timestamp":1784332800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Am J Rhinol&amp;#65533;Allergy"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Endoscopic dacryocystorhinostomy (eDCR) is the preferred surgical treatment for nasolacrimal duct obstruction. However, long-term outcome data and reliable predictors of surgical success remain limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess long-term functional outcomes of eDCR and identify factors associated with recurrence in a large single-center cohort with long-term follow-up.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a retrospective cohort study including all patients who underwent primary endonasal eDCR between 1998 and 2022 at a tertiary referral center. Primary outcomes were functional success (absence of epiphora) after first and, if necessary, second surgery, and time to recurrence following primary eDCR. Recurrence-free survival was analyzed using Kaplan\u2013Meier methods and Cox proportional hazards regression. Secondary outcomes included concordance among preoperative diagnostic tests and perioperative complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      A total of 280 patients underwent 313 primary unilateral eDCR procedures. Functional success after first surgery was achieved in 86.9% of cases, with 41 recurrences (13.1%). After secondary procedures, 95.2% of operated sides were symptom-free. Estimated recurrence-free survival was 93.5% at 1 year, 90.8% at 3 years, and 88.5% at 5 years. On multivariable analysis, concomitant unciformectomy was independently associated with a reduced risk of recurrence (hazard ratio 0.27; 95% CI, 0.13-0.56;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001). Agreement among preoperative diagnostic tests was limited, with only fair concordance between fluorescein testing or dacryography and dacryo-CT-scan imaging (Cohen's \u03ba 0.25-0.29). No major surgical complications were observed.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>eDCR provides durable long-term relief of epiphora with high functional success rates. Concomitant unciformectomy appears to reduce the risk of recurrence significantly and may represent an important surgical step in optimizing long-term outcomes. Limited concordance among preoperative diagnostic tests supports the use of a complementary diagnostic approach in clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/19458924261469353","type":"journal-article","created":{"date-parts":[[2026,7,18]],"date-time":"2026-07-18T14:53:18Z","timestamp":1784386398000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predictors of Success and Long-Term Outcome in Endoscopic Dacryocystorhinostomy: Single-Center Study"],"prefix":"10.1177","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-7428-5431","authenticated-orcid":false,"given":"Stephen Jacques","family":"Alzuphar","sequence":"first","affiliation":[{"name":"R\u00e9seau Hospitalier Neuch\u00e2telois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1373-7100","authenticated-orcid":false,"given":"Kazumichi","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Institute for Airways Disease, Hyogo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5574-3210","authenticated-orcid":false,"given":"Roland","family":"Giger","sequence":"additional","affiliation":[{"name":"Bern University Hospital and University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-1469-9168","authenticated-orcid":false,"given":"Jean-Jacques","family":"Tritten","sequence":"additional","affiliation":[{"name":"R\u00e9seau Hospitalier Neuch\u00e2telois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-6506-4368","authenticated-orcid":false,"given":"Jean Paul","family":"Friedrich","sequence":"additional","affiliation":[{"name":"R\u00e9seau Hospitalier Neuch\u00e2telois"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5666-2092","authenticated-orcid":false,"given":"Samuel","family":"Tschopp","sequence":"additional","affiliation":[{"name":"Bern University Hospital and University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-6684-1150","authenticated-orcid":false,"given":"Yves","family":"Jaquet","sequence":"additional","affiliation":[{"name":"R\u00e9seau Hospitalier Neuch\u00e2telois"},{"name":"Bern University Hospital and University of Bern"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,7,18]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2012.26.3789"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27989"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.2500\/ajra.2010.24.3393"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.2500\/ajr.2007.21.3095"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1177\/000348941112000403"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0161-6420(01)00977-0"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00417-012-1992-x"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2018.07.006"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2015.08.007"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1442-9071.2009.02094.x"},{"key":"e_1_3_3_12_2","first-page":"385","article-title":"Nuovo metodo conservatori di cura radicale delle suppurazioni cronici del sacco lacrimale (dacriocistorinostomia)","volume":"10","author":"A T","year":"1904","unstructured":"A T. 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