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The tear is essential for the eye to keep moist and provide its normal function. It is produced by the tear glands located under the eyelids and tears glands, and tear ducts carry the produced tear to the nasal cavity. The obstruction of these ducts due to various reasons such as medications, conjunctivochalasis, or recurrent infection is called "Epiphora." Epiphora impairs normal tear channeling into the nose. The dacryocystorhinostomy procedure(DCR union which involves fistulization of the lacrimal sac into the nasal cavity, may relieve the symptoms of epiphora. Dacryocystorhinostomy surgery is a procedure that aims to eliminate fluid and mucus retention within the lacrimal sac and to increase tear drainage for relief of epiphora.


Dacryocystorhinostomy is much more common for adults than for children. Before dacryocystorhinostomy option, doctors may firstly recommend less invasive treatments such as warm compresses, massage, and antibiotics for an infection. If the symptoms are severe or getting more disturbing patients may need a dacryocystorhinostomy surgery.

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If your tear duct is infected and you experience swelling and tenderness around your eye, eye irritation, and abnormal mucus discharge, your doctor will examine if you need dacryocystorhinostomy or some other or initial treatments.  It’s important to realize that not everyone who has a blocked tear duct will need to undergo the dacryocystorhinostomy surgery. 


Patients need to inform their doctors what medicines or supplements they are currently taking, or any substances they are sensitive to.  At the pre-operative assessment of dacryocystorhinostomy, doctors inform the patients about the preparations they need to make such as altering medications. If they are using aspirin tablets, they should stop using them as they can lead to bleeding during or after the operation. Patients also should stop smoking as it can affect the surgical or recovery process.


Basically, a dacryocystorhinostomy procedure involves removing the bone adjacent to the nasolacrimal sac and joining the lacrimal sac with the lateral nasal mucosa to bypass the nasolacrimal duct obstruction. Over the years, there have been some modifications in various surgical steps of the dacryocystorhinostomy to achieve a better surgical outcome without really altering its basic concept. The procedure may be performed under monitored sedation or general anesthesia depending on the surgeon and the patient's preference.The operation takes about 1 to 1,5 hours, and elderly patients or those having a general anesthetic are advised to stay in hospital over-night. Otherwise, the patient can usually leave the hospital on the same day, although they need someone to drive them home.


Patients may have a bit of nose bleeding for a couple of days after the dacryocystorhinostomy procedure. Recovery period generally takes less than one week. After DCR, patients will be advised to use eye drops four times a day. They also may be given a nasal spray to loosen crusts inside their nose. They should stay away from the strenuous activities the first week after the operation and take a couple of days off until their first clinic visit.


As in any surgery, dacryocystorhinostomy procedure carries some risks and complications as well:

  • Bleeding
  • Infection
  • Displacing the tube
  • Bruising

 

Excessive bleeding rarely occurs, but if patients experience this, a nasal pack may need to be used to stop the bleeding after the operation.


Possible side effects of dacryocystorhinostomy may include:

  • Infection
  • Scars (from external surgery)
  • Stuffy nose
  • Bruising

Dacryocystorhinostomy has a great advantage. The success rate of the surgery is close to 100%. Even if the epiphora is repeated, it can be completely corrected without any effect.


Patients experience a significant increase in their quality of life after dacryocystorhinostomy surgery because the symptoms of epiphora that disturb them disappear. The repeat rate is also quite low. After a short recovery period, patients can easily resume their normal lives without any problem occurred because of epiphora.


What Is Dacryocystorhinostomy?

Dacryocystorhinostomy is a surgical procedure to relieve the tear duct blockage and its symptoms.

 

Is Dacryocystorhinostomy Painful?

Dacryocystorhinostomy is performed under general or local anesthesia. Hence the patients do not feel any pain during the procedure. If post-op pain occurs, patients may use prescribed medicines or nasal sprays to relieve the pain or discomfort.

 

What Does Dacryocystorhinostomy Cost?

Dacryocystorhinostomy is a highly successful procedure that requires limited follow-up and cost-effectiveness. Complications are rare, and patient satisfaction is high.The cost of the procedure may vary depending on the location of the surgery, the reputation of the selected clinic, and the additional costs that may arise.


This content is written and reviewed by our medical content team in August, 2019.