Endonasal dacryocystorhinostomy in the primary treatment of acute dacryocystitis with abscess formation

Purpose: To determine whether endonasal dacryocystorhinostomy may constitut e effective primary treatment of acute dacryocystitis with lacrimal sac abs cess formation. Methods: This: was a retrospective review of a series of 24 patients with a cute dacryocystitis and lacrimal sac abscess who underwent endonasal dacryo cystorhinostomy as a primary procedure. Outcome measures included resolutio n of signs and symptoms of acute dacryocystitis as well as intranasal ostiu m patency as assessed by lacrimal irrigation. Results: Pain was relieved in all patients within 3 days of surgery, and sw elling resolved in all patients by 9 days after surgery. Ostium patency, as defined by the absence of epiphora, and free lacrimal irrigation was achie ved in 20 (83%) of 24 patients, with follow-up of 27 to 59 months (mean, 40 months). Recurrent epiphora developed in four patients; recurrent dacryocy stitis developed in none. Conclusions: Endonasal dacryocystorhinostomy may be a useful option in the treatment of acute dacryocystitis with abscess formation.