There were 112 patients who fulfilled the criterions to be enclosed in the study. 86 of the patients were women and 26 were men. They all received a letter with enclosed questionnaires. Those that did not reply within eight weeks did receive the questionnaire a second time. In total 67 (60%) patients did answer the questionnaires and from these patients were 33 patients operated by external DCR and 34 patients operated by endonasal DCR. Because many patients had bilateral lacrimal problems there were several bilateral DCR operations and for this reason a total of 77 cases of endonasal DCR and 56 cases of external DCR were performed.
The group operated by external DCR had a total Lac-Q score of 469 points before the operation and 148 points after the operation. A reduction of 69%. Their score on social inconvenience was before the operation 143 points and after the operation 48 points, which gives a reduction of 66,4%. The group’s degree of satisfaction was 273 points out of 320 points (one patient did not answer the question). Regarding the scar on the side of the nose 4 patients were disturbed. Two of these patients considered the scar ugly and one patient complained of trouble wearing glasses. After the operation the patients stayed home from work for 2-14 days and the median time was 3,5 days. In the group were also many (17) retired people.
The group operated by endonasal DCR had a total Lac-Q score of 441 points before the operation and 98 points after the operation. A reduction of 77,7%. Their score on social inconvenience was before the operation 147 points and after the operation 37 points, which gives a reduction of 74,8%. The group’s degree of satisfaction was 294 points out of 340 points. After the operation the patients stayed at home not working for 0-7 days and the median time was 2 days.
A paired t-test to analyze the social impact by the operation gave an improvement of 2,7 points (p<0,001, 95% CI: 2,3;3,1) in Lac-Q. The reduction of symptoms after the operation was measured by a paired t-test. The result showed a reduction of 5,96 points (p<0,001, 95% CI: 5,05;6,88). The total (both symptoms and social inconvenience) effect on Lac-Q by the operation on all patients was analyzed with a paired t-test. The result showed an average improvement of 9,9 points (p<0,001, 95% CI: 7,424;9,823) in Lac-Q score.
The majority of patients were very satisfied with the operation where 38 patients gave highest (10 point) score and only very few gave less than 6 points. To see if there was any difference in satisfaction depending on external or endonasal DCR had been performed a Mann-Whitney Test was applied and gave a P value of 0,76. The median for both methods was 10 and because of that the P value became insignificant. That means the majority (38 of 66) were as satisfied as was possible. This proved there was no difference in satisfaction between the two operated groups.
A t-test was used to evaluate if there was any difference in satisfaction (social inconvenience and lacrimal symptoms) between the two operating techniques. The average improvement was 0,30 points lower with the endoscopic technique, but, it was not statistically significant (p=0,84, 95% CI: -3,29;2,68). However, both the techniques gave an improvement of 10 points.