Evaluation of Patients for Endoscopic DCR: Sac Syringing and Radionuclide Scintigraphy

To evaluate the importance of sac syringing and radionuclide scintigraphy for pre operative work up of patients with epiphora. In this study, from the year Jan. 2013 to Jan. 2016, patients of epiphora were subjected to radionuclide scintigraphy of lacrimal apparatus in addition to sac syringing and probing. The significance of adding radionuclide scintigraphy in pre op assessment of epiphora was statistically assessed. 146 lacrimal systems were enrolled in the study. Out of them, 89 were males and 57 were females. The mean age of the patients was 42 years. Of the 146 lacrimal systems evaluated, scintigraphy detected 25 cases of common canalicular block versus 8 cases by sac syringing. Also radionuclide scintigraphy was able to detect 11 cases of functional obstruction which were patent on syringing. Results were analysed statistically. Correct diagnosis of site of obstruction is essential to predict a better surgical outcome of endoscopic DCR as it is a highly successful surgical procedure which can be done in distal NLDO only. We recommend that all patients of epiphora should undergo sac syringing as an initial test. This is a simple, inexpensive procedure which can be done as an OPD procedure in a short time. However, radionuclide scintigraphy can be added as an additional investigation to more accurately delineate site of block. It is an objective test and delineates the lacrimal system both anatomically and functionally. Also it diagnoses functional block which appears patent on syringing.