Tear duct surgery may become necessary when your tear ducts are blocked and your tears do not drain effectively. This article introduces you to endoscopic tear duct surgery. Keep reading if you’d like to learn more about it.

What Are Tear Ducts?

The nasolacrimal ducts, also known as tears ducts, appear in the outer corner of your eye, closest to your nose. They are tunnel-like structures that form part of the drainage system, connecting your facial bones and nostrils and running beneath the skin.

Tears are continually released into your eyes by glands located inside your eyelids and on the white areas of your eyes. Every time you blink, the tears are pushed into the tear ducts. These ducts are then responsible for draining them away.

What Causes Tear Duct Blockage?

The exact causes of tear duct blockage are not known yet, but they may include reasons such as:

●    Congenital anatomical issues

●    Chronic sinusitis that causes constant inflammation of the area

●    Narrowing of or complete blockage of the passage by tumors or polyps

●    Conjunctivitis

●    Injury to the nose

Remember, not everyone whose tear ducts are blocked requires tear duct surgery. Initially, your doctor might suggest non-invasive and conservative methods such as applying a warm compress, massages, and antibiotics (if an infection is causing the blockage). Only when these methods don’t work effectively does a person need to consider surgery.

The Two Types of Tear Duct Surgery

Tear duct surgery, or dacryocystorhinostomy (DCR), can be performed endoscopically (minimally invasive procedure) and externally. This will be decided based on your preferences and the doctor’s expert opinion after reviewing your CT scan and MRI reports.

Endoscopic DCR

During this procedure, your surgeon will bypass the tear duct by establishing a new passage straight from the lacrimal sac to the nasal cavity. The surgeon does this by cutting a hole in the bone that overlies the lacrimal sac while working via the nasal canal under endoscopic vision.

The lacrimal sac and your nasal cavities subsequently become connected. To keep the new tear duct open, the surgeon inserts a tiny tube at the place of the incision. No sutures are necessary after an endoscopic DCR.

External DCR

Under this method, your surgeon makes a passage from the lacrimal sac to the nasal cavity from the outside. They do this by approaching the area through an incision made in the space beneath your eye and near your nose.

Then, the surgeon makes a tiny hole in the bone beneath the skin using this incision. The lacrimal sac and the nasal cavity are then connected through this aperture, and a tiny tube is left in place to help keep the new tear duct open. The incision will then be closed using sutures. Bear in mind that this method does leave a physical scar.

Post-surgery, you will require close follow-up care with your surgeon to ensure your surgical site heals well.

If you’re experiencing symptoms of a blocked tear duct—such as excessive tearing—and would like to discuss it with an expert, contact Dr. Eric F. Succar, MD. Dr. Succar is a board-certified otolaryngologist (ENT) who practices adult and pediatric ENT specializing in complex sinus, nasal, and skull base disorders. You can visit his clinic in Waterford, MI (Oakland County). He also treats patients from Bloomfield Hills, Clarkston, Pontiac, and Troy, MI. You can reach him at (248) 254-8900 or contact him online.