Canaliculorhinostomy—Indications and Surgical Results

To report the surgical results of canaliculorhinostomy for patients with distal canalicular obstruction and lacking a structurally functional lacrimal sac who would otherwise require a conjunctivodacryocystorhinostomy (CDCR) with Jones tube placement. Retrospective observational case series. Setting: Single tertiary institution. Period: November 1994 to June 2011. Patient Population: Sixteen patients with canalicular obstruction at or beyond 8 mm from the punctum, with an absent or unidentifiable lacrimal sac. Intervention: Patients underwent canaliculorhinostomy, whereby direct anastomosis of the canaliculi or common canaliculus to the nasal mucosa was performed. Main Outcome Measures: Anatomic and functional success. Our study comprised 16 patients with a mean age of 44.9 ± 21.9 years. Ten (62.5%) were female and 6 (37.5%) male. Mean duration of follow-up was 7.8 years. Causes of an absent or unidentifiable lacrimal sac included previous trauma (n = 8, 50.0%), previous dacryocystorhinostomy (n = 4, 25.0%), chronic dacryocystitis (n = 3, 18.8%), and previous dacryocystectomy (n = 1, 6.2%). Anastomoses between the upper and lower canaliculi and the nasal mucosa was performed in 6 patients, while that between the common canaliculus and nasal mucosa was performed in 10. Anatomic and functional success rates were 87.5% (n = 14) and 81.3% (n = 13), respectively. Canaliculorhinostomy has reasonable success rates and provides an effective surgical alternative for a group of patients in whom CDCR with Jones tube placement would otherwise have been indicated.