Efficacy of endonasal dacryocystorhinostomy, using ‘cold steel’ instruments without stenting, in treatment of distal nasolacrimal duct obstruction

2011 ◽  
Vol 125 (6) ◽  
pp. 590-594 ◽  
Author(s):  
L Ananth ◽  
P Hosamani ◽  
G Chary
Keyword(s):  
Complete Resolution ◽  
Cost Effective ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Success Rates ◽  
Duct Obstruction ◽  
Lacrimal System ◽  
Reliable Procedure ◽  
One Year

AbstractObjective:To assess the efficacy of an endonasal dacryocystorhinostomy technique using conventional instruments, without the use of any adjunctive techniques.Study design:Prospective, non-randomised, cohort study.Methods:Patients diagnosed with nasolacrimal duct obstruction between January 2006 and December 2008 were included in the study. Seventy-eight endonasal dacryocystorhinostomies (primary or revision) were performed with conventional ‘cold steel’ instruments. The technique involved complete exposure and marsupialisation of the lacrimal sac. No adjunctive procedures were used. Success was defined as complete resolution of epiphora and a patent lacrimal system, evaluated by lacrimal irrigation and endoscopy, one year post-operatively.Results:Seventy-four of the 78 cases were symptom-free after a minimum follow up of 12 months, giving an overall success rate of 94.9 per cent. The success rates for primary and revision cases were 95.5 and 90.9 per cent, respectively.Conclusion:Meticulous surgical technique can ensure high success rates with the use of conventional cold steel instruments, without the use of adjunctive procedures, making endonasal dacryocystorhinostomy a cost-effective, reliable procedure.

Non-Surgical Crigler massage for treatment of congenital nasolacrimal duct obstruction in infants below one year age.

2021 ◽  
Vol 28 (06) ◽  
pp. 804-807
Author(s):  
Mohammad Alam
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Medical Sciences ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Topical Antibiotics ◽  
One Year ◽  
Medical University ◽  
Age Range

Objective: To analyse the efficacy of non-surgical Crigler massage for treatment of congenital nasolacrimal duct obstruction in infants below one year age. Study Design:  Setting: Khyber Medical University Institute of Medical Sciences (KMU-IMS) KDA Teaching Hospital Kohat. Period: April 2014 to June 2019.  Materials & Methods:  on Non-Surgical Crigler massage for conservative   treatment of congenital nasolacrimal duct obstruction in infants below one year age. Proper proforma was designed for documentation of patients and their follow up. Consents were taken from their parents. 93 patients with age range of 2-6 months with congenital nasolacrimal duct obstruction were included in the study out of which 51(54.83%) were male and 42(45.16%) were female. 79(84.94%) patients had unilateral while 14(15.05%) patients had bilateral congenital nasolacrimal duct obstruction. So total 107 eyes with congenital nasolacrimal duct obstruction were included. Parents were trained and educated for conservative non-surgical Crigler massage of the lacrimal sacs along with topical antibiotics. Parents were instructed to do 8-10 massage four times a day. Patients were followed up to one year of age. 11 patients were lost from complete follow up in which 9 had unilateral while 2 patients had bilateral congenital nasolacrimal duct obstruction. Cumulatively 13 eyes were missed from follow up. Final results of remaining 82 patients with 94 eyes were analysed. Results: Out of 94 eyes epiphora was abolished with negative regurgitation test in 68(72.34%) patients at the end of one year while in 26(27.65%) the procedure was failed. Conclusion: Non-surgical conservative Crigler massage is very successful in management of congenital nasolacrimal duct obstruction.

Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction

2009 ◽  
Vol 123 (11) ◽  
pp. 1226-1228 ◽  
Author(s):  
S Agarwal
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Published Data ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
External Dacryocystorhinostomy ◽  
One Year ◽  
Conventional Manner ◽  
Gain Access

AbstractObjective:To evaluate the results of endoscopic dacryocystorhinostomy performed to treat acquired nasolacrimal duct obstruction.Design:Retrospective analysis of the outcome of endoscopic dacryocystorhinostomy performed in the conventional manner (i.e. without power instruments or laser) to treat acquired nasolacrimal duct obstruction.Subjects:Outcomes for 300 patients with acquired nasolacrimal duct obstruction were evaluated. Cases with congenital or traumatic blockages were excluded. All the cases were evaluated for nasolacrimal duct blockage by the syringing and regurgitation test. Surgery was performed under local anaesthesia with sedation. Follow up was conducted by syringing and nasal endoscopy, up to one year. Results were compared with published data for endoscopic and external dacryocystorhinostomy.Results:Outcomes were evaluated subjectively using patient symptoms, syringing results and endoscopic appearance. All cases were symptom-free following endoscopic dacryocystorhinostomy. Revision surgery was performed in 18 cases. Stents were placed in 10 patients, of which two developed granulations. Septoplasty was performed in 25 cases to gain access to the lacrimal sac area.Conclusion:The results were comparable with published data for endoscopic and external dacryocystorhinostomy.

scholarly journals Symptom score questionnaire for nasolacrimal duct obstruction in adults--a novel tool to assess the outcome after endoscopic dacryocystorhinostomy

2010 ◽  
Vol 48 (4) ◽  
pp. 446-451
Author(s):  
G. Smirnov ◽  
H. Tuomilehto ◽  
H. Kokki ◽  
T. Kemppainen ◽  
V. Kiviniemi ◽  
...  
Keyword(s):  
Symptom Score ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Subjective Outcome ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Glasgow Benefit Inventory ◽  
One Year

BACKGROUND: The incidence of nasolacrimal pathway obstruction increases with age, and dacryocystorhinostomy (DCR) is a commonly applied surgical technique to treat severe cases. However, no disease-specific tools to assess the symptoms and the subjective outcome after DCR have been established. We have developed a specific Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS) questionnaire to evaluate the outcome, and tested it in a prospective clinical trial. STUDY DESIGN: Prospective clinical follow-up study. METHODS: Sixty-eight consecutive primary endoscopic dacryocystorhinostomy (EN-DCR) procedures were performed in 64 patients during 2004-2008. Preoperatively and during the three follow-up visits (at 1 week, 2 and 6 months), the patients filled in the NLDO-SS, and at the second and third follow-up visits they also filled in the Glasgow Benefit Inventory (GBI) questionnaire. At one year after the operation, a GBI questionnaire was sent to the patients. RESULTS: The surgical success rate of EN-DCR was 93 %. EN-DCR resulted in a significant reduction in all of the eight symptoms scores of the NLDO-SS (p= 0.001). The GBI scores indicated a significant benefit at 2 months (+37 (SD; 28) and an even higher benefit at 6 months after surgery (+52 (SD; 29), p= 0.001), but no further improvement was found between 6 and 12 months (+52 vs +52, p= 1.0). The correlation between the total GBI and NLDO-SS was significant (p=0.001). CONCLUSIONS: EN-DCR significantly improves the quality of life as measured by the GBI. The NLDO-SS correlated with the GBI and gave more information about the benefits after EN-DCR than GBI alone. The NLDO-SS proved to be an effective tool to evaluate lacrimal obstructions and EN-DCR benefits. Further studies to validate NLDO-SS are needed.

scholarly journals Endonasal endoscopic dacryocystorhinostomy in Misrata central hospital, Libya

2018 ◽  
Vol 4 (2) ◽  
pp. 317
Author(s):  
Abdussalam M. Jahan ◽  
Yousef M. Eldanfur ◽  
Abdulhakim Ben Ghuzi
Keyword(s):  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Success Rates ◽  
Central Hospital ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Endoscopic Dcr ◽  
One Year ◽  
The Right

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Dacryocystorhinostomy (DCR) is a surgical procedure performed for the relief of nasolacrimal duct obstruction (NLDO). This procedure involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. It can be performed externally or endoscopically.<strong> </strong>The aim of this study is to<strong> </strong>evaluate the success rates and complications of endoscopic dacryocystorhinostomy<strong> </strong>in Misurata Central Hospital. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">Prospective study includes 30 patients admitted to the ENT-Department, Misrata Central Hospital over a period of one year, starting from April 2016 to March 2017. They underwent endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Thirty patients were included in the study. Their age ranged from 11-60 years, with mean age of 33 years. Most of the patients were in the age range of 31 to 50 years. There were 24 (80%) females and 6 (20%) males. The most common complaint of patients before surgery was epiphora. There was more obstruction on left side -21 (70%) than on the right side-9 (30%). Bilateral involvement was not seen. Three patients (10%) were required septoplasty during the endoscopic DCR procedure. Twenty four out of thirty (80%) patients had complete resolution. There were no any significant major complications observed in any patient in our study. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Endoscopic DCR is safe, successful procedure for the treatment of nasolacrimal duct obstruction and has several advantages over conventional external approach.</span></p>

Spontaneous resolution rates in congenital nasolacrimal duct obstruction managed with massage or topical antibiotics compared with observation alone

2021 ◽  
pp. bjophthalmol-2021-318853
Author(s):  
Brian G Mohney ◽  
Saraniya Sathiamoorthi ◽  
Ryan D Frank
Keyword(s):  
Medical Records ◽  
Population Based ◽  
Nasolacrimal Duct ◽  
Spontaneous Resolution ◽  
Nasolacrimal Duct Obstruction ◽  
Olmsted County ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Topical Antibiotics

Background/aimsTo determine if nasolacrimal massage or topical antibiotics are associated with higher rates of resolution compared with observation alone in a population-based cohort of infants with congenital nasolacrimal duct obstruction (CNLDO).MethodsThe medical records of all children <5 years diagnosed with CNLDO while residing in Olmsted County, Minnesota from 1 January 1995 through 31 December 2004 were retrospectively reviewed for type of management and non-surgical resolution of tearing.ResultsAmong 1958 infants diagnosed and followed for CNLDO, 516 (26.4%) were merely observed, 506 (25.8%) were prescribed massage alone, 485 (24.8%) were prescribed at least one course of topical antibiotics, 397 (20.3%) were prescribed both topical antibiotics and massage, and 54 (2.8%) had no documented therapy. Non-surgical resolution, occurring in 1669 (85.2%) during a median follow-up of 3.1 months (range: 1 week–248 months), was 74.6% for the merely observed, 89.7% for those prescribed digital massage, 87.0% for those prescribed antibiotics and 90.7% for those treated with both. This comparison was significant in unadjusted (p<0.001) and multivariable comparisons (p<0.001).ConclusionPrescribing topical antibiotics or digital massage for infants with CNLDO in this cohort, individually or in combination, was associated with a higher rate of spontaneous resolution than observation alone.

Dacryostenosis in Newborns: Probing, or Syringing, or Both?

2000 ◽  
Vol 10 (2) ◽  
pp. 128-131 ◽  
Author(s):  
A.A. Tahat
Keyword(s):  
Methylene Blue ◽  
High Pressure ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
The Third ◽  
Lacrimal System ◽  
Age Range ◽  
Nasolacrimal Ducts

Purpose This prospective study was designed to establish whether it is more effective to treat symptomatic congenital nasolacrimal duct obstruction by probing, or high-pressure irrigation, or both. Methods During the period February 1991 to January 1999, 228 infants (300 nasolacrimal ducts) were examined (132 males, 96 females, age range 12–13 months). These patients were divided into three groups of 100 ducts each. The first group was probed only; in the second group the nasolacrimal ducts were irrigated under high pressure using methylene blue-stained saline, and the third group was probed and irrigated in the same setting. The procedures were done under light general anesthesia. Results Ninety-one ducts in the first group improved after probing. In the second group 64 ducts improved after irrigation. In the third group 96 ducts improved after both probing and irrigation. Conclusions To treat symptomatic congenital nasolacrimal duct obstruction, it is more effective to combine high-pressure irrigation and probing. This gives a better success rate, first in treatment and secondarily, permitting intraoperative verification of the patency of the excretory lacrimal system.

scholarly journals Non endoscopic endonasal dacryocystorhinostomy versus external dacryocystorhinostomy

1970 ◽  
Vol 6 (4) ◽  
pp. 437-442 ◽  
Author(s):  
BR Sharma
Keyword(s):  
Direct Method ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Successful Outcome ◽  
Success Rates ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Surgical Success ◽  
External Dacryocystorhinostomy

Aims and Objectives: To compare the success rates of non endoscopic endonasal dacryocystorhinostomy and conventional external dacryocystorhinostomy for the surgical management of primary acquired nasolacrimal duct obstruction. Materials and methods: A retrospective, nonrandomized, comparative interventional case series of 302 patients who underwent either endonasal or external dacryocystorhinostomy over a period of 2 years. All surgeries were performed by a single surgeon and patients with primary nasolacrimal duct obstruction with a minimum of 6 months post operative follow up were included in the study. While external dacryocystorhinostomy was performed using traditional technique, endonasal dacryocystorhinostomy was performed using direct method of nonendoscopic visualization. Results: Of the 302 cases included in the study 165 patients had endonasal dacryocystorhinostomy whereas 137 underwent external dacryocystorhinostomy. Success was defined by resolution of symptoms of tearing, a negative fluorescein dye disappearance test and patency of the canalicular system on lacrimal irrigation. In the external dacryocystorhinostomy group 124 (90.5%) patients had surgical success whereas 146 (88.5%) of the endonasal dacryocystorhinostomy patients had successful outcome. The overall success rate was 89.4%, and the difference of surgical success between the two groups was not statistically significant ( P=0.57). Conclusion: Non endoscopic endonasal dacryocystorhinostomy gives surgical results comparable to those of external dacryocystorhinostomy and is a viable alternative where dacryocystorhinostomy is indicated for primary acquired nasolacrimal duct obstruction. Key words: Endonasal Dacryocystorhinostomy (ENDCR), External Dacryocystorhinostomy (EXDCR), Primary acquired nasolacrimal duct obstruction (PANLDO)   doi: 10.3126/kumj.v6i4.1731  Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 437-442     

scholarly journals Outcomes and comparison of nasolacrimal probing for patients older than 12 months

2020 ◽  
Vol 12 ◽  
pp. 251584142092713
Author(s):  
Kürsad Ramazan Zor ◽  
Erkut Küçük ◽  
Zeynep Yılmaz Öztorun
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Older Age ◽  
Nasolacrimal Duct Obstruction ◽  
Age Group ◽  
Success Rates ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Initial Surgery ◽  
First Choice

Objective: In this study, we report the results of probing done in our clinic. We also want investigate role of late probing on outcome, especially in children older than 24 and 48 months. Methods: We retrospectively evaluated records of patients who underwent probing under general anaesthesia due to congenital nasolacrimal duct obstruction between 2013 and 2017 in Nigde Ömer Halisdemir University Faculty of Medicine in Nigde, Turkey. Success rates of probing for different age groups were compared. Results: 143 eyes of 123 patients were included in the study. Overall success rate was 93.7% (134 eyes out of 143). We found the success rate as 95.5 in 12–18 months age group, 93.3% in 18–24 months age group, 93.8% in the 24–48 months age group, 86.6% in the 48 months and older age group. Overall success rate in 24 months and older age group was 91.5%. The second operation was performed on seven of the nine patients where the initial surgery failed, and successful results were achieved in six patients. Success rate was 100% after the second surgery in patients older than 48 months. Conclusion: The success rate of probing is high in patients with congenital nasolacrimal duct obstruction from 12 to 84 months. In patients with congenital nasolacrimal duct obstruction who are older than 48 months probing is effective and should be first-choice in this age group in management of congenital nasolacrimal duct obstruction. Probing may be used even in older patients who had previous unsuccessful probing.

Success rates of endoscopic-assisted probing for congenital nasolacrimal duct obstruction in children

2013 ◽  
Vol 127 (8) ◽  
pp. 794-798 ◽  
Author(s):  
S Theodoropoulou ◽  
M S M Sutherland ◽  
K Haddow ◽  
A Blaikie
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Developmental Abnormality ◽  
Success Rates ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Fluorescein Dye ◽  
Age Range ◽  
Test Result

AbstractObjective:To determine the success rate of initial probing in children with congenital nasolacrimal duct obstruction at different ages, using nasal endoscopy.Methods:Fifty eyes of 38 consecutive children with congenital nasolacrimal duct obstruction underwent endoscopic nasolacrimal duct probing under general anaesthesia. Patients were followed up for at least three months. Probing success was defined as complete remission of symptoms and a normal fluorescein dye disappearance test result.Results:The age range of patients was 17–109 months. The success rates of probing were: 100 per cent (29 out of 29) for cases of stenosis at the lower nasolacrimal duct, 100 per cent (7 out of 7) for functional epiphora cases and 92.86 per cent (13 out of 14) for nasolacrimal atresia cases. Overall, there was only one child for whom the probing treatment for nasolacrimal duct obstruction was not successful; this child had Down's syndrome and a more complex developmental abnormality of the nasolacrimal duct. Age and site of obstruction were not found to significantly affect the outcome of probing.Conclusion:Probing of the nasolacrimal system using an endoscopic approach allows direct visualisation of the nasolacrimal duct. This can facilitate diagnosis of the anomaly and significantly increase the procedure success rate.

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