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A prospective comparative study evaluated endoscopic endonasal dacryocystorhinostomy (DCR) against external DCR for acquired partial nasolacrimal duct obstruction. Both procedures aim to bypass the obstructed drainage pathway and establish a functional connection between the lacrimal sac and nasal cavity, but they differ in incision, nasal access, visualization, and postoperative management. The study is relevant to oculoplastic practice because procedure choice often depends on the anatomy of the obstruction, nasal findings, surgeon expertise, and patient priorities. Endoscopic approaches avoid a facial skin incision and allow direct nasal visualization, while external DCR remains a widely established and highly effective technique. The evidence does not support treating the approaches as competitors with a single universal winner. Instead, both can be appropriate depending on the clinical scenario. For HCP education, the paper is a useful reminder to separate anatomical success from patient-centered considerations such as scar concerns, operative time, nasal pathology, and the need for adjunctive procedures. Preoperative imaging or lacrimal assessment should be integrated where indicated to clarify the level and nature of obstruction before selecting the surgical route.
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A prospective comparative study evaluated endoscopic endonasal dacryocystorhinostomy (DCR) against external DCR for acquired partial nasolacrimal duct obstruction. Both procedures aim to bypass the obstructed drainage pathway and establish a functional connection between the lacrimal sac and nasal cavity, but they differ in incision, nasal access, visualization, and postoperative management. The study is relevant to oculoplastic practice because procedure choice often depends on the anatomy of the obstruction, nasal findings, surgeon expertise, and patient priorities. Endoscopic approaches avoid a facial skin incision and allow direct nasal visualization, while external DCR remains a widely established and highly effective technique. The evidence does not support treating the approaches as competitors with a single universal winner. Instead, both can be appropriate depending on the clinical scenario. For HCP education, the paper is a useful reminder to separate anatomical success from patient-centered considerations such as scar concerns, operative time, nasal pathology, and the need for adjunctive procedures. Preoperative imaging or lacrimal assessment should be integrated where indicated to clarify the level and nature of obstruction before selecting the surgical route.
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