Evidence map›Paper›PMID 41786947›Full record

SynthesisEuropean archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery2026

Endoscopic dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction: A systematic review and pooled analysis of powered vs. non-powered technique.

Antonio Daloiso, Piergiorgio Gaudioso, Michael Negrisolo, Stefano Settimi, Dario Antonio Mele, Claudio Parrilla, Jacopo Galli, Elisabetta Zanoletti, Piero Nicolai, Marco Ferrari

Abstract readSystematic Review
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In one paragraph

Synthesis in European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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0citing papers in PubMed
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1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

0 citing papers in PubMed.

No citing paper in PubMed yet.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Antonio DaloisoSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padova, Via Giustiniani 2, Padova, 35128, Italy. antonio.daloiso@studenti.unipd.it.ORCID http://orcid.org/0000-0002-3687-8814
Piergiorgio GaudiosoSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padova, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0000-0001-6219-9180
Michael NegrisoloSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padova, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0009-0000-5001-0731
Stefano SettimiUnit of Otorhinolaryngology, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy.ORCID http://orcid.org/0000-0003-0104-1501
Dario Antonio MeleUnit of Otorhinolaryngology, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy.
Claudio ParrillaUnit of Otorhinolaryngology, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy.ORCID http://orcid.org/0000-0001-5878-7668
Jacopo GalliUnit of Otorhinolaryngology, A. Gemelli University Hospital Foundation IRCCS, Rome, Italy.ORCID http://orcid.org/0000-0003-1599-4573
Elisabetta ZanolettiSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padova, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0000-0003-3455-2295
Piero NicolaiSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padova, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0000-0003-0443-3519
Marco FerrariSection of Otorhinolaryngology - Head and Neck Surgery, Department of Neuroscience, University of Padova, Via Giustiniani 2, Padova, 35128, Italy.ORCID http://orcid.org/0000-0002-4023-0121

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeEndoscopic dacryocystorhinostomy (eDCR) has become the standard surgical treatment for primary acquired nasolacrimal duct obstruction (PANDO), demonstrating safety and success rates comparable to external DCR. However, surgical failure remains a concern, often related to aberrant mucosal healing, synechiae formation, and ostium restenosis. The optimal surgical approach, particularly regarding powered versus non-powered techniques and the role of adjunctive treatments such as silicone stents and mucosal flaps, remains debated.

methodsA systematic review and pooled analysis were conducted in accordance with PRISMA guidelines. The protocol was registered on PROSPERO (CRD420251014988). PubMed, Scopus, and Web of Science were searched through March 2025. Eligible studies included adults with PANDO undergoing primary eDCR, with detailed reporting of technique, outcomes, and at least 50 cases. Data were extracted and stratified by surgical approach (powered vs. non-powered) and adjunctive treatments (stenting, mucosal flaps).

resultsA total of 107 studies comprising 17,415 DCRs were included. Overall surgical success was 87.5%, with no significant difference between powered (87.7%) and non-powered (87.6%) approaches (OR 0.95, 95% CI 0.87-1.05, p = 0.316). Laser-assisted DCR was associated with significantly lower success (OR 0.80, p = 0.001). Mucosal flap preservation improved outcomes, while silicone stenting showed no consistent benefit. Non-powered techniques were associated with shorter operative times.

conclusionsPowered and non-powered eDCR techniques demonstrate comparable efficacy in managing PANDO. Non-powered approaches, particularly with mucosal flap preservation, may offer practical advantages, reduced morbidity, and shorter operative times, supporting their role as a valuable alternative in clinical practice.

Indexed as

DacryocystorhinostomyEndoscopyLacrimal Duct ObstructionNasolacrimal DuctHumansStentsSurgical FlapsTreatment OutcomeDacryocystorhinostomyDrillEndoscopic surgeryEpiphoraLacrimal sacNasolacrimal duct obstructionPowered

Identifiers

PMID41786947

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.