Epiphora (Excessive Tearing)
Epiphora is excessive tearing that results in tears flowing onto the face. This can result for a variety of reasons. The problem can have to do with overproduction of tears by the lacrimal gland or inadequate drainage of tears through the lacrimal (tear drainage) system and into the nose. Depending on the cause of epiphora, the treatment options can vary.
If your problem is due to insufficient drainage of tears through the lacrimal system and into the nose, then your lacrimal (tear drainage) system might be obstructed. This is typically evaluated by an ophthalmologist. In the event that a part of your lacrimal system is obstructed or blocked, you might benefit from a dacryocystorhinostomy.
Endoscopic (Dacryocystorhinostomy) DCR
A dacryocystorhinostomy, or DCR, is a procedure performed to alleviated lacrimal system or lacrimal sac obstruction in order to facilitate drainage of tears into the nose. Traditionally, the procedure has been performed externally - meaning a small incision is made on your face near your lacrimal (tear drainage) sac in order to perform the procedure. The procedure entails widening the drainage pathway into the nose in order to improve the drainage of tears into the nose.
A newer technique that has essentially equivalent outcomes is the endoscopic DCR. In an endoscopic DCR, there are no incisions made in your face. The entire procedure is performed through the nose. A small amount of bone that separates your lacrimal sac from your nose is removed, and an incision is made into the lacrimal sac from within your nasal cavity. The drainage pathway for your tears is widened similarly to how it would be if it was performed externally.
In both external and endoscopic DCR, a small tube is temporarily left in place within your tear duct system to help maintain the widened opening. This is usually removed in the clinic some weeks after your procedure.
Endoscopic DCR
An endoscopic DCR is performed to relieve epiphora caused by nasolacrimal duct obstruction.