The length of unsutured mucosal margins in external dacryocystorhinostomy

PURPOSE: To compare the extent of mucosal margins remaining unsutured at the end of external dacryocys, torhinostomy (DCR) using single or double flap techniques and to evaluate the influence on outcome. DESIGN: Prospective, consecutive case series. METHODS: The number and length of mucosal Mar. gins remaining unsutured at the end of external DCR were evaluated in 64 patients. Mucosal anastomosis was performed using either a conservative (group 1) or extended (group 2) double flap, or a single flap (group 3) dissection. Patients were selected for group 1 if the regional anatomy permitted the desired dissection. All other patients were randomized to group 2 or 3. The mean length of unsutured mucosal margins was calculated for each group. Subjects were followed up to 12 months, with final success rate recorded. RESULTS: In groups 1, 2, and 3 respectively: 11, 24 and 29 patients were recruited; four, 12, and 10 mucosal margins remained unsutured; and the mean length of unsutured mucosal margins was 16.36 mm (SD = 2.8), 70.66 mm (SD = 9.3), and 62.00 mm (SD = 6.0). The mean length of unsutured mucosal margins was significantly different, although groups 1 and 2 collectively did not have a significantly different mean length of unsutured mucosal margin from group 3. Mean follow,up was 11 months (SD = 2.2), 63 patients (98-43%) had a successful outcome with no significant difference among groups (P =.429). CONCLUSION: Different patterns of mucosal dissection in external DCR create a different number and extent of unsutured mucosal margins which do not appear to adversely affect the success rate of external DCR. (C) 2004 by Elsevier Inc. All rights reserved