Powered endoscopic dacryocystorhinostomy with mucosal flaps

The technique described for endoscopic dacryocystorhinostomy (DCR) allows complete exposure of the lacrimal sac after creation of a large bony ostium. In addition, preservation of the lacrimal mucosa allows apposition of the nasal mucosa to the lacrimal mucosa, allowing healing by first intention and thereby avoiding granulation tissue formation with subsequent scarring. These principles have been espoused as the corner stones for success for the traditional external DCR, but can now be achieved without an external incision or disruption of the lacrimal pump seen with the external approach. This technique has a 95% anatomical patency, which is as good as the best results obtained by the external DCR.