Purpose: This literature review examines the literature on surgical modifications and post-operative strategies designed to minimize visible scarring following external dacryocystorhinostomy (Ext-DCR).
Methods: A comprehensive search of PubMed, Medline, Embase, Cochrane Central, and CINAHL databases was performed on July 25th 2024, to identify studies evaluating scar formation after Ext-DCR. Studies were included if they assessed incision techniques, closure methods, or post-operative care protocols and reported aesthetic outcomes related to scar visibility.
Results: Forty studies comprising 3750 Ext-DCR procedures with scar reports from 3715 individuals met the inclusion criteria. The prevalence of visible scarring varied widely (0-50%), though most studies reported rates below 10%. Techniques associated with improved aesthetic outcomes included alternative incision designs, minimal incision approaches, and sutureless skin closures.
Conclusion: Various surgical modifications have demonstrated potential in reducing visible scarring after Ext-DCR; however, no single technique has achieved universal acceptance. Tailoring incision design and closure techniques based on patient-specific factors, including skin type and aesthetic concerns, has been reported to improve outcomes. Future studies should incorporate standardized scar assessment scales to facilitate direct comparisons and optimize best practices in Ext-DCR surgery.
Keywords: cicatrix; dacryocystorhinostomy; esthetics; patient satisfaction; surgical incisions; suture techniques.
© 2025 Boberg-Ans et al.