Patient satisfaction following endoscopic endonasal dacryocystorhinostomy: a quality of life study

Purpose To assess the subjective success and quality of life of adult patients post endoscopic endonasal dacryocystorhinostomy (EE-DCR) for acquired nasolacrimal duct obstruction. Design Retrospective, questionnaire study performed at least 6 months post EE-DCR. Participants Hundred and ten of the 282 consecutive patients who underwent EE-DCR. Methods A standardised questionnaire (Glasgow Benefit Inventory, GBI) was used to analyse the quality of life. The questionnaire examines four parameters, providing total, subscale, social, and physical scores. Main outcome measures We aimed to assess patient experience following EE-DCR surgery. Total GBI scores range from −100 to +100, the former reflecting maximal negative benefit and corresponding to subjective worsening of tearing and impact on quality of life. Any positive score reflects a satisfactory surgical outcome and +100 represents maximal positive benefit. A score of zero is no perceived benefit. Results The average age was 62 years, 63% were female. In three of the parameters measured, there was a subjective improvement post surgery: subscale score 22.16 (95% CI: 15.23–29.09), total score 15.04 (95% CI: 9.74–20.35), and social support score 4.67 (95% CI: 0.93–8.42). Physical health scored −4.47 (95% CI: −10.25 to 1.32). Secondary analyses demonstrate no statistical significance with respect to outcome whether a trainee or consultant performed the procedure. Younger patients (under split median of 63.5) had a better total score 19.04 (95% CI: 11.35–27.74) than those older than 63.5 years (11.04, 95% CI: 3.61–18.47). Discussion This study shows that EE-DCR gave patients improvement in quality of life, proven by a validated questionnaire. The mean total score of 15.04 found in our study compares with the 18.7 recorded by Feretis et al in 2009. Results were irrespective of the grade of surgeon, similar to the findings of Fayers et al for functional successes. Conclusion This study supports the use of EE-DCR for the improvement of quality of life in adult patients.