Role of stenting in endonasal dacryocystorhinostomy: multiple challenges of the current approach

The standard procedure for dacryocystorhinostomy (DCR) employs routine stenting during the operation. According to different sources, the overall stent indwelling time ranges from six weeks to six months or even longer. Placement of a stent promotes rhinostoma formation and prevents stenosis. Since the introduction of this technique, many studies have been conducted to assess the results of DCR with and without the use of stents, the stent material, as well as the time period after which the stents were removed. This review discusses the relevant literature on stenting in endonasal dacryocystorhinostomy, which was available in PubMed over the last ten years. Equally good endonasal dacryocystorhinostomy (enDCR) results have been obtained for patients with and without a stent. However, the use of stents is sometimes associated with multiple additional complications: formation of granulations at an earlier postoperative period, infection of the lacrimal drainage system, and canalicular laceration. The use of Mitomycin C, topical steroids, antibiotics, and silver nitrate has a different impact on reducing the occurrence of these complications. Further studies are needed to develop more accurate indications for the use of stents during enDCR, as well as the timing of their removal, and the use of adjunctive topical medication.