POSTOPERATIVE COMPLICATIONS FOLLOWING DACRYOCYSTORHINOSTOMY:A REVIEW OF CLINICAL FEATURES DIAGNOSIS AND MANAGEMENT

Background. Dacryocystorhinostomy (DCR) is one of the principal surgical procedures used to treat obstruction of the lacrimal drainage system, chronic dacryocystitis, and persistent epiphora. Although modern external and endoscopic techniques demonstrate high clinical effectiveness, postoperative complications may occur and can compromise the patency of the newly created lacrimal drainage pathway. Objective. To systematize the principal early and late complications occurring after dacryocystorhinostomy and to describe their clinical manifestations, possible mechanisms, diagnostic approaches, and preventive principles. Materials and Methods. A review of contemporary literature concerning lacrimal drainage surgery, external and endoscopic dacryocystorhinostomy, and postoperative complications was performed. Complications were classified according to the time of onset and presumed mechanism. Particular attention was paid to epistaxis, postoperative edema, infection, granulation tissue, cicatricial stenosis of the rhinostomy, synechiae, silicone stent-related complications, persistent epiphora, and recurrent dacryocystitis. Results. The principal causes of an unsatisfactory postoperative result are associated with impaired patency of the rhinostomy, excessive granulation, cicatricial narrowing, synechiae, and selected stent-related problems. Persistent or recurrent epiphora requires differential assessment because it does not necessarily indicate complete anatomical closure of the rhinostomy. Endoscopic follow-up is important for early identification of granulation tissue, synechiae, scar formation, and abnormalities of the silicone stent. Conclusion. Early recognition of postoperative complications and structured ophthalmological and otorhinolaryngological follow-up may facilitate timely intervention and help preserve the functional outcome of dacryocystorhinostomy.