Rhinological Status of Patients with Nasolacrimal Duct Obstruction

Abstract Introduction Studying the state of the nasal cavity and its sinuses and the morphometric parameters of the inferior nasal conchae, as well as a comparative analysis of obtained values in patients with primary (PANDO) and secondary acquired nasolacrimal duct obstruction (SALDO), is relevant. Objective To study the rhinological status of patients with PANDO) and SALDO). Methods The present study was based on the results of computed tomography (CT) dacryocystography in patients with PANDO (n = 45) and SALDO due to exposure to radioactive iodine (n = 14). The control group included CT images of paranasal sinuses in patients with no pathology (n = 49). Rhinological status according to the Newman and Lund-Mackay scales and volume of the inferior nasal conchae were assessed. Statistical processing included nonparametric statistics methods; χ2 Pearson test; and the Spearman rank correlation method. Results The difference in values of the Newman and Lund-Mackay scales for the tested groups was significant. A significant difference in scores by the Newman scale was revealed when comparing the results of patients with SALDO and PANDO. Comparing the scores by the Lund-Mackay scale, a significant difference was found between the results of patients with SALDO and PANDO and between the results of patients with PANDO and the control group. Conclusion It was demonstrated that the rhinological status of patients with PANDO was worse than that of patients with SALDO and of subjects in the control group. No connection was found between the volume of the inferior nasal conchae and the development of lacrimal duct obstruction.

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Estimation of Eyelid Pressure Using a Blepharo-Tensiometer in Patients with Functional Nasolacrimal Duct Obstruction

Journal of Ophthalmology ◽

10.1155/2018/8792102 ◽

2018 ◽

Vol 2018 ◽

pp. 1-6 ◽

Cited By ~ 1

Author(s):

Jinsoo Kim ◽

Sang-Mok Lee ◽

Youn Joo Choi ◽

Min Joung Lee

Keyword(s):

Diagnostic Value ◽

Lower Eyelid ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Control Group ◽

Duct Obstruction ◽

Silicone Intubation ◽

The Difference ◽

The Relationship

Purpose. To compare the eyelid pressure between patients with functional nasolacrimal duct obstruction (FNLDO) and normal controls using blepharo-tensiometer, and to evaluate the relationship between eyelid pressure and the outcomes of silicone intubation (SI) in patients with FNLDO. Study design. Prospective case-control study. Methods. We enrolled 36 eyes of 36 patients with suspected FNLDO who underwent SI and 36 healthy eyes of age-matched controls. One eye of each patient with FNLDO was randomly selected for analysis. The eyelid pressure was estimated using a blepharo-tensiometer and compared between the control and FNLDO groups. The relationship between eyelid pressure and clinical variables was analyzed. The outcomes of SI were assessed at 6 months after surgery using subjective and objective criteria. Results. The eyelid pressure was significantly lower in the FNLDO group than in the control group P=0.008. In the control group, the eyelid pressure was correlated with age P<0.001 and lower eyelid laxity P=0.016. In the FNLDO group, the eyelid pressure was only correlated with age P<0.001. The success rate of SI for FNLDO was 69.4% (25 of 36 eyes). The eyelid pressure was higher in the surgical success subgroup than in the failure subgroup, although the difference was not statistically significant P=0.08. Conclusions. Our results suggest that the eyelid pressure measured using a blepharo-tensiometer has a diagnostic value since it is decreased in patients with FNLDO. The role of eyelid pressure as a possible predictor of the outcomes of SI for FNLDO should be investigated in further studies. This trial is registered with KCT0002828.

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Epiphora in patients after high-dose radioiodine therapy

POINT OF VIEW EAST – WEST ◽

10.25276/2410-1257-2021-1-54-55 ◽

2021 ◽

pp. 54-55

Author(s):

V.D. Yartsev ◽

◽

E.L. Atkova ◽

Keyword(s):

Radioiodine Therapy ◽

Therapy Group ◽

Nasolacrimal Duct ◽

Positive Answer ◽

Nasolacrimal Duct Obstruction ◽

High Dose ◽

Duct Obstruction ◽

The Difference ◽

Group 2 ◽

Group 1

Purpose. To estimate the frequency of tearing in patients after high-dose radioiodine therapy. Materials and Methods. The survey was conducted in 500 patients after radioiodine therapy (group 1) and 654 volunteers (group 2). We asked whether the respondent noticed epiphora last month, in case of a positive answer we specified how many times during the day it was necessary to wipe the tear, comparing the result with Munk scale. Results. The patients of group 1 noticed tearing in 232 cases, the respondents of group 2 noticed it in 186 cases. Epiphora was more frequent in patients of group 1 (46 % of cases), rather than in volunteers of group 2 (27 % of cases). Excessive tearing was noticed in 8.8 % of patients of group 1 and 3.5 % of respondents of group 2. The difference was statistically significant. Conclusion. 8.8 % of patients complain about excessive tearing after high-dose radioiodine therapy, which is more frequent than in the general population. This may be related to secondary acquired nasolacrimal duct obstruction. Key words: epiphora, nasolacrimal duct obstruction, radioiodine therapy.

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Role of silicone stenting in endoscopic dacryocystorhinostomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200136 ◽

2020 ◽

Vol 6 (2) ◽

pp. 248

Author(s):

Abdussalam M. Jahan ◽

Yousef M. Eldanfur ◽

Abdulhakim B. Ghuzi

Keyword(s):

Success Rate ◽

Medical Center ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

P Value ◽

Success Rates ◽

Duct Obstruction ◽

Significant Difference ◽

Silicone Stent ◽

Endoscopic Dcr

Background: Dacryocystorhinostomy (DCR) is a surgical procedure performed to relief nasolacrimal duct obstruction, which involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. Closure of the rhinostomy opening was considered a major factor for surgical failure. Use of silicone stent in endoscopic DCR to improve the success rate of the operation have been tried by many surgeons. In this study we assess the success rates of endoscopic DCR with and without silicone stents.Methods: Prospective study includes 30 patients were operated in the Department of ENT, Misrata Medical Center, from April 2017 to March 2018. They underwent endonasal endoscopic DCR for primary acquired nasolacrimal duct obstruction. These patients were randomly divided in two groups: A and B with 15 patients in each group. The group A patients underwent endoscopic DCR with silicone stent and group B patients underwent endoscopic DCR without stent. The results were statistically analyzed by chi-square test. Results: 30 patients were included in this study, their age ranged from 17 to 60 years, complaining of epiphora, 24 (80%) were females and 6 (20%) were males. The success rate was higher in patients with silicone stent (93.33%) as compared to patients without silicone stent (86.67%) but this difference in the results is not statistically significant (As p value is 0.542 which is >0.05).Conclusions: Endoscopic DCR is safe, successful procedure for treatment of nasolacrimal duct obstruction and there was no significant difference in the success rates of performing endonasal DCR with silicone or without silicone stents.

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Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients

International Archives of Otorhinolaryngology ◽

10.1055/s-0038-1675394 ◽

2019 ◽

Vol 23 (02) ◽

pp. 191-195

Author(s):

Islam R. Herzallah ◽

Osama A. Marglani ◽

Ameen Z. Alherabi ◽

Nuha S. Faraj ◽

Deemah H. Bukhari

Keyword(s):

Quality Of Life ◽

Success Rate ◽

Symptom Score ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Safe Procedure ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Significant Difference

Introduction Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective To evaluate the feasibility and the outcome of simultaneous bilateral Endo-DCR and its impact on the quality of life of the patients. Methods We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients.

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Endoscopic endonasal dacryocystorhinostomy vs nasolacrimal duct intubation in pediatric nasolacrimal duct obstruction - a comparative study

QJM ◽

10.1093/qjmed/hcab109.029 ◽

2021 ◽

Vol 114 (Supplement_1) ◽

Author(s):

Rana Atia ◽

Magda Samy ◽

Sheriff Elwan ◽

Thanaa Helmy ◽

Ashraf Shaat ◽

...

Keyword(s):

Postoperative Complications ◽

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Endoscopic Endonasal ◽

Duct Obstruction ◽

Tube Removal ◽

Group A ◽

The Difference ◽

Group B

Abstract Study design; Pilot randomized controlled study. Objective To compare success rates of endoscopic endonasal dacryocystorhinostomy and nasolacrimal duct intubation in congenital nasolacrimal duct obstruction (NLDO) in a trial to define the superiority of either technique. Patients & Methods Sixty-six eyes of 61 patients were diagnosed as having epiphora and mucopurulent discharge due to congenital NLDO. The patients were randomly divided into two groups; Group A; 33 eyes of 28 patients (treated by probing and silicone intubation only (NLDI)) and Group B; 33 eyes of 33 patients (treated by endoscopic endonasal dacryocystorhinostomy and silicone tube intubation (EDCR). All tubes were removed 6 months after the operation. Results The success rate, defined as complete resolution of clinical symptoms and signs after 6 months of follow up, was 72.7 % in Group A and 81.8% in Group B. Although the success rate was higher in Group B, yet the difference was shown to be statistically nonsignificant. Preoperative symptoms were assessed postoperatively after tube removal. Complete cure had a higher rate of occurrence in Group B than in Group A (27eyes (81.8%) versus 25 eyes of 22 patients (75.8%) respectively). Postoperative positive fluorescein dye disappearance test (FDDT) after tube removal was more in Group B than in Group A (27 eyes (81.8) versus 24 eyes of 21 patients (72.7 %) respectively). In Group A, silicone tubes had to be repositioned due to prolapse in 3 eyes of 3 patients (9.1%) and had to be removed early in 3 eyes of 3 patients (9.1%) due to failure of repositioning. In Group B, silicone tubes did not require early tube extraction before the date of removal in any of the patients. Intraoperative, there was only one case (3.0%) of fat prolapse during EDCR in Group B with no subsequent postoperative complications. Hemostasis did not represent a problem in any of the patients. Postoperative complications occurred more in Group B than Group A (21 eyes (63.6%) versus 13 eyes of 13 patients (39.4 %) respectively). Late complications occurred more in Group B than Group A (18 eyes (54.5%) versus 12 eyes of 12 patients (36.4%) respectively) in the form of persistent epiphora and tube prolapse. Conclusion The success rate of pediatric EDCR was higher than that of pediatric NLDI. The difference was statistically non-significant. Complications were comparable between the two groups. The study, being pilot in its comparative aspect between endoscopy and intubation, opens the horizon for further study on a larger group that probably will expand this difference.

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Refraction in Children with Unilateral and Bilateral Congenital Nasolacrimal Duct Obstruction

Journal of Biomedical and Clinical Research ◽

10.2478/jbcr-2019-0007 ◽

2019 ◽

Vol 12 (1) ◽

pp. 47-52

Author(s):

Krasina P. Valcheva ◽

Snejana V. Murgova

Keyword(s):

Risk Factors ◽

Visual Acuity ◽

Management Plan ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Significant Difference ◽

Refractive Status ◽

General Populations

Summary The study aimed to identify the type of refraction in children with unilateral and bilateral congenital nasolacrimal duct obstruction (CNLDO) who underwent nasolacrimal duct probing. One hundred and twelve children aged 1.8 to 13 years, diagnosed with CNLDO, were included in a retrospective study. All the patients had their visual acuity examined, and their refractive status was evaluated. The refractive errors of both eyes were noted, followed by an appropriate management plan. Of the 112 children, 79 (70.5%) had a unilateral obstruction, and 33 (29.5%) had bilateral obstruction. Nine children (11.4%) in the former group and six children (18.2%) in the latter group were with visual acuity <0.8. The most frequent refractive error among the studied children was hyperopia. No statistically significant difference (p>0.05) between refraction of the two eyes in the evaluated children were found. Amblyopia risk factors were identified in 9 of the patients (8.0%). CNLDO did not adversely affect the refractive status. However, amblyogenic risk factors were found more often in our patients, as compared to general populations. Therefore, a detailed evaluation should be performed to find out these risk factors.

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Balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction

European Journal of Ophthalmology ◽

10.1177/1120672119895906 ◽

2019 ◽

pp. 112067211989590

Author(s):

Inbal Gazit ◽

Eran Pras ◽

Lior Or ◽

Morris E Hartstein

Keyword(s):

Complete Resolution ◽

Age Groups ◽

Balloon Catheter ◽

Primary Treatment ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Significant Difference ◽

Partial Success

Purpose: The aim of this study is to report the outcome of balloon catheter dilation as the primary treatment of congenital nasolacrimal duct obstruction in children of all ages. Methods: A 10-year retrospective study of 148 children (270 eyes), aged 9 to 159 months (mean age: 29.6 ± 17.7 months), who previously had not undergone a nasolacrimal surgical procedure and who presented with clinical signs of nasolacrimal duct obstruction, was conducted. All children underwent balloon catheter dilation of the nasolacrimal duct. Results: Treatment success, defined as complete resolution of nasolacrimal duct obstruction symptoms present at follow-up visits at 1 week and up to 6 months after surgery, was 87% (234 of 270 eyes). Partial success was defined as occasional tearing which was acceptable to parents and present in 3% (nine eyes). Only 10% of the children underwent a second procedure due to complete failure. In a sub-analysis by age groups—under 18 months, between 18 and 36 months, and above 36 months—complete resolution rates were 85%, 93%, and 77%, and partial success rates were 3%, 3%, and 4%, respectively. There was a statistically significant difference between the age groups ( p = .007). Conclusion: In this large cohort of patients with nasolacrimal duct obstruction, balloon catheter dilation was successful as a primary treatment for congenital nasolacrimal duct obstruction, particularly under the age of 36 months.

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Balloon Dacryocystoplasty with Pushed Monocanalicular Intubation as a Primary Management for Primary Acquired Nasolacrimal Duct Obstruction

10.21203/rs.3.rs-752605/v1 ◽

2021 ◽

Author(s):

Chun-Chieh Lai ◽

Cheng-Ju Yang ◽

Chia-Chen Lin ◽

Yi-Chun Chi

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Combination Group ◽

Duct Obstruction ◽

Surgical Success ◽

Significant Difference ◽

Silicone Stent ◽

Primary Management ◽

Monocanalicular Intubation

Abstract Though dacryocystorhinostomy (DCR) has long served as the gold treatment for primary nasolacrimal duct obstruction (PANDO), balloon dacryocystoplasty (DCP) and silicone stent intubation were applied especially in partial PANDO in the attempts to avoid osteotomy and reduce invasiveness. Herein, we present the results of the combined procedures with balloon DCP and pushed monocanalicular intubation in complete PANDO, and comparison of the combination to balloon DCP alone. We retrospectively reviewed 72 eyes of 56 patients, including 37 eyes of 29 patients in the combination group and 35 eyes of 28 patients in the balloon DCP alone group. There was no significant difference in the success rate between antegrade balloon DCP with and without pushed MCI in general. Nevertheless, interestingly the former procedure was associated with significantly higher surgical success rate than the latter in younger patients.

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Comparison of the efficacies of 1.0mm and 1.5mm silicone tubes for the treatment of nasolacrimal duct obstruction

10.21203/rs.3.rs-1182481/v1 ◽

2021 ◽

Author(s):

Jutaro Nakamura ◽

Tomoyuki Kamao ◽

Arisa Mitani ◽

Nobuhisa Mizuki ◽

Atsushi Shiraishi

Keyword(s):

Recurrence Rate ◽

Patency Rate ◽

Large Diameter ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Silicone Tube ◽

Duct Obstruction ◽

Tube Removal ◽

The Difference ◽

One Year

Abstract Purpose: We compared the difference in postoperative patency rates due to the differences in the diameter of silicone tubes used for bicanalicular intubation for the treatment of nasolacrimal duct obstruction (NLDO). Methods: Patients diagnosed with NLDO at Ehime University Hospital between August 2013 and November 2020 who underwent endoscopic-assisted nasolacrimal duct intubation (ENDI) were included in the study. The patients involved were 130 cases and 157 sides (age 72.6 ± 11.3 years) who were eligible for follow-up for more than six months after the removal of the lacrimal silicone tube. The postoperative recurrence rate was compared retrospectively based on the difference in tube caliber. The patients were divided into two groups: those intubated with a 1.5-mm large diameter tube (Group LD) and those with a 1.0-mm normal diameter tube (Group ND). The survival rates of the two groups at one year after tube removal were compared by Kaplan-Meier's curve and Restricted mean survival time (RMST) method with τ = 365 days. Results: There were no significant differences in age, gender, or observation period after tube removal between the two groups. Meanwhile, the preoperative occlusion period was significantly longer in the ND group. The recurrence rate after tube removal was significantly lower in the LD group (12 / 85 sides, 14.1%) compared to the ND group (27 / 72 sides, 37.5%) (p = 0.001). The patency rate at one year after removal of the lacrimal tube was 0.857 (0.754-0.919) in the LD group and 0.739 (0.617-0.828) in the ND group. In comparing patency rates by the RMST method at τ = 365 days, the RMST difference, RMST ratio, and RMTL ratio were significantly higher in the LD group at p = 0.045, 0.052, and 0.046, respectively. Conclusion: Regarding the bicanalicular silicone tube intubation, the patency rate at one year after removal was significantly higher in the thicker tubes with a diameter of 1.5 mm compared with that of a diameter of 1.0 mm for the treatment of NLDO.

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Comparative Evaluation of 99mTc-Pertechnetate, 99mTc-Diphosphonate, 99mTc-Solcocitran, 99mTc-Iron-Ascorbic Acid and 67Ga-Citrate as Brain Scanning Agents

Nuklearmedizin ◽

10.1055/s-0037-1620592 ◽

1982 ◽

Vol 21 (06) ◽

pp. 265-273.

Author(s):

Ó. G. Björnsson ◽

O. J. Björnsson ◽

D. Davídsson ◽

E. Pétursson

Keyword(s):

Ascorbic Acid ◽

Rank Correlation ◽

Correlation Method ◽

99Mtc Pertechnetate ◽

Group I ◽

Rank Correlation Method ◽

Kendall’S Τ ◽

Significant Difference ◽

Good Agreement ◽

67Ga Citrate

The uptake of 99mTc-pertechnetate (TcO4), 99mTc-iron-ascorbic acid (Feasc), 99mTc-Solcocitran (Solcocitran), 99mTc-diphosphonate (HEDP) and 67Ga-citrate (Ga) in various brain lesions was compared. Influence of time from injection was also studied on the first three compounds. A rank correlation method was used to compare the scans which were judged visually by three independent observers. There was good agreement between the observers, as measured by Kendall’s τ, but the concordance between rankings within the same type of lesion, as measured by Kendall’s W, was rather poor. There was no significant difference in the uptake of TcO4, Feasc and Solcocitran. Ga showed generally poor uptake and its uptake in tumours and infarcts did not differ significantly. However, when HEDP and TcO4 were compared in two groups (I: Infarcts, haemorrhages and bone invading meningiomas, and II: Tumours not invaded into bone) a highly significant difference was obtained with much higher uptake of HEDP in Group I.

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