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Hammer-Chisel Technique in Endoscopic Dacryocystorhinostomy

We performed a prospective evaluation of endoscopic hammer-chisel dacryocystorhinostomy (DCR) procedures on 62 eyes of 44 patients (40 female and 4 male) with chronic epiphora or dacryocystitis (26 unilateral and 18 bilateral). The technique included chisel removal of bone over the lacrimal sac. The follow-up period was 12 to 54 months (mean, 28 months), and the patients' ages ranged from 17 to 67 years (mean, 35.5 years). The success rate of the consecutive endoscopic hammer-chisel DCR procedures was 87%. During operation, 8 patients had mild mucosal hemorrhage, which did not prevent the successful completion of the operation. Excellent patient tolerance was observed, with minimal morbidity and no major complications. As compared to the external approach, endoscopic hammer-chisel DCR is less traumatic, is less time-consuming, and is practical and cosmetically convenient, with minimal perioperative and postoperative complications. It also allows the simultaneous correction of any intranasal disease. It requires minimal instrumentation and is a relatively easy and fast technique.