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The Scientific World Journal
Volume 2015, Article ID 170841, 4 pages
Research Article

Comparison of Modifications in Flap Anastomosis Patterns and Skin Incision Types for External Dacryocystorhinostomy: Anterior-Only Flap Anastomosis with W Skin Incision versus Anterior and Posterior Flap Anastomosis with Linear Skin Incision

Sisli Hamidiye Etfal Training and Research Hospital, Halaskargazi Avenue, Etfal Street, Sisli, 34371 Istanbul, Turkey

Received 23 January 2015; Accepted 9 June 2015

Academic Editor: Jimmy S. M. Lai

Copyright © 2015 Burcu Dirim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Purpose. To compare the outcomes of external dacryocystorhinostomy (E-DCR) by using two different flap anastomosis patterns and skin incision types. Methods. This study included 79 patients (88 eyes) with lacrimal drainage system disorders who underwent E-DCR surgery. Fifty eyes of 44 patients (group A) underwent E-DCR by suturing anterior and posterior flaps (H-flap) of the lacrimal sac with curvilinear skin incision whereas in 38 eyes of 35 patients (group B) DCR was performed by suturing only anterior flaps (U-flap) with W skin incision. Results. The success rate was evaluated according to lacrimal patency and scar assessment scores. Patency was achieved in 78 patients (88.6%). In terms of groups, patency was 44 eyes (88.0%) in group A and 34 eyes (89.5%) in group B. There was no statistically significant difference in the success rates of lacrimal patency between the two groups. Further, there was no statistically significant difference concerning cutaneous scar scores. Conclusion. Our study suggests that anastomoses of only anterior flaps or both anterior and posterior flaps have similar success rates; suturing only anterior flaps is easier to perform and shortens the operative time. In addition, W skin incision is a reasonable alternative to curvilinear incision for reducing scar formation.