Abstract
Purpose
Endoscopic endonasal dacryocystorhinostomy is performed to treat epiphora in patients
with chronic dacryocystitis. However, the potential application of an endonasal dacryocystectomy
for malignancies involving the lacrimal system (lacrimal sac and nasolacrimal duct)
has not been sufficiently investigated. This study aims to assess the feasibility
of an endonasal dacryocystectomy and to investigate its efficacy with clinical case
scenarios.
Materials and Methods
An endoscopic endonasal dacryocystectomy was conducted on two cadaveric specimens
(four sides). An endonasal dacryocystectomy for tumors involving the lacrimal system
was performed in six patients. The feasibility of performing an endonasal dacryocystectomy
was assessed on cadaveric dissection, and the efficacy of endonasal dacryocystectomy
for patients with involvement of the lacrimal system was evaluated.
Results
Endonasal extirpation of the lacrimal system was feasible on four cadaveric sides.
For five patients with sinonasal malignancies (two adenoid cystic carcinoma, one squamous
cell carcinoma, two mucosal melanoma) and one with lacrimal sac melanoma, endonasal
dacryocystectomy was successfully performed and negative margins achieved in all six
patients. One patient harbored postoperative epiphora, no other comorbidities were
detected. With an average follow-up of 18 months, no regional recurrence at the lacrimal
system was detected.
Conclusion
To perform an endoscopic endonasal dacryocystectomy is feasible on cadaveric specimens.
For sinonasal malignancies secondary involving the lacrimal system, it is possible
to conduct an endonasal resection when the indication is appropriately selected.
Keywords
nasolacrimal duct - lacrimal sac - dacryocystectomy - endonasal - sinonasal malignancies
