Dacryocystorhinostomy (DCR) : Tips & Tricks for Postgraduates
Dacryocystorhinostomy (DCR), a century-old procedure described by Toti in the early 1900s, remains the gold standard for treating Nasolacrimal Duct Obstruction (NLDO).1 For any other procedure related to the treatment of NLDO, they are all compared and evaluated against DCR. The surgical anatomy overlaps the areas of expertise of an ophthalmologist or an oculoplastic specialist and an otolaryngologist, as the majority of the Nasolacrimal duct lies in the nasal cavity. Therefore, both external and endonasal approaches are available. In 1893, Caldwell first described the endonasal approach of DCR,2 and almost a decade later, in 1904, Toti described the external approach of DCR, which became the gold standard for the treatment of NLDO. The main goal of DCR is to create a fistulous tract lined with epithelium from the lacrimal sac into the nasal cavity. Although the endonasal approach was first described, it did not gain popularity due to the non-availability of nasal endoscopes and diffic
Dr. Saurabh Kamal