PURPOSE. To describe a simple modification of fashioning the mucosal flap for endonasal endoscopic dacryocystorhinostomy (EES-DCR) in Chinese patients and investigate its efficacy.

METHODS. In all, 120 patients with unilateral primary chronic dacryocystitis (PCD) were randomized into two groups: the new shaped nasal mucosal flap group (group A) and the removed nasal mucosal flap group (group B). All patients underwent standard EES-DCR. The group A was performed a new shaped nasal mucosal flap covering the bared bone around the opened sac and the group B was removed the nasal mucosal flap uncovering the bared bone. Patients were followed up for one year. The occurrence of granulation tissue, the proliferation of scars tissue and success rate of EES-DCR was compared.

RESULTS. Our study included 54 patients in the group A and 57 patients in the group B. During process of review, The occurrence of granulation tissue was at the ostium margins account for 15%(8/54) in group A and 39%(22/57) in group B(P＜0.05). At the one-year review, scars were present in 5 patients in group A compared with 18 in group B(P＜0.05). The success rate of EES-DCR was 98% (53/54) in group A and 84%(48/57) in group B (P＜0.05).

CONCLUSIONS. The simple modification of fashioning the nasal mucosal flap can effectively cover the bared bone around the opened sac and reduce formation of granulation tissue, lessen the risk of scaring formation and closure of ostium, thus improve the success of EES-DCR in Chinese people.