The Agger Nasi Dacryocystorhinostomy: A New Technique for Endoscopic Dacryocystorhinostomy

Objective: Endoscopic dacryocystorhinostomy (DCR) is the gold-standard procedure for the treatment of nasolacrimal duct obstruction, aiming to open the lacrimal sac (LS) directly into the nasal cavity and thus re-establish drainage of the tear pathways. The present study proposes a new surgical technique that relates the agger nasi (AN) cell to the LS and advocates for its systematic opening with the hypothesis that this technique promotes greater space for healing of the nasal tissues and facilitates postoperative control with a low rate of surgical failure. Methods: We analyzed 36 patients who underwent DCR using the AN as a key landmark over a 2-year period. The criteria for assessment of surgical success were patency of the ostium that communicates the LS with the nasal cavity and absence of signi!cant epiphora according to the Munk scale. Results: Patency of the drainage ostium was observed in the late postoperative period in 100% of cases. Epiphora was absent in 86.48% of those cases followed for at least 6 months after surgery. Conclusion: Agger nasi dacryocystorhinostomy (AN-DCR) involves opening the AN as a landmark for wide and complete exposure of the LS. This approach is a safe and highly e"ective method that yields good postoperative outcomes.