Air reflux following endoscopic dacryocystorhinostomy

Abstract

Purpose: To evaluate the incidence of air reflux following endoscopic dacryocystorhinostomy and determine its association with symptomatic control following surgery.

Methods: Questionnaire assessment was performed for adult patients 1 year following primary endoscopic dacryocystorhinostomy for nasolacrimal duct obstruction at the Hong Kong Eye Hospital.

Results: 43 patients were included. Overall, 97.7% of patients reported improved symptoms after endoscopic dacryocystorhinostomy. Air reflux was present in 14 patients (32.6%), with 78.6% noting moderate-to-severe symptoms, although the majority (71.4%) did not consider it a nuisance. All patients with air reflux noted symptomatic improvement. There was no significant difference in symptom improvement between patients with and without air reflux (p = 1.000). Air reflux was found to have a high specificity (100%) but poor sensitivity (33%) in reflecting symptom control, and had a positive predictive value of 100% and negative predictive value of 3.4%.

Conclusion: The presence of air reflux did not reflect the success of endoscopic dacryocystorhinostomy in managing symptomatic nasolacrimal duct obstruction. Nonetheless its presence was well tolerated and can be reassuring to patients as it indicates lacrimal drainage patency.