Assisted locoregional anaesthesia for endoscopic endonasal dacryocystorhinostomy with concomitant septoplasty

The standard treatment for nasolacrimal duct obstruction has been dacryocystorhinostomy (DCR) surgery. Endoscopic endonasal dacryocystorhinostomy (EnDCR) has been gaining popularity, largely because of technological advances in endoscopes and other modern instruments used for rhinologic surgery. EnDCR can be performed under locoregional anaesthesia in elderly and medically unfit patients for general anaesthesia. The EnDCR often requires septal or turbinate surgery to optimize access to the lacrimal area. Here, we report a revision EnDCR using cold steel tools with powered drills under locoregional anaesthesia in an unfit elderly patient with chronic excessive tearing because of chronic dacryocystitis.