Does the Timing of Silicone Tube Removal Following External Dacryocystorhinostomy Affect Patients' Symptoms?

Introduction: Many patients in Nepal travel vast distances to have their surgeries in Kathmandu. They often remain close by until their follow-up visit for their silicone tube removal, which contributes to a large financial burden on them and their families. Hence, reducing the time for which silicone tubes remain in situ following external dacryocystorhinostomy (DCR) provides significant benefits to patients. Furthermore, this is the first comparative study which has successfully demonstrated the earliest timeframe for which silicone tubes can be removed following DCR in the medical literature. Methods: A randomized controlled trial consisting of 144 patients was designed to compare patient outcomes after early (2 weeks postoperatively) versus standard (6 weeks postoperatively) removal of silicone stents. The success of their procedures was determined when patients were assessed both symptomatically and anatomically at their 6-month follow-up. Results: The surgical success in both groups was high at 97.8% collectively in both groups and there were only a small number of patients who were lost to follow-up (5 patients) at 6 months. There was no statistical difference at removing silicone stents at 2 or 6 weeks postoperatively. Conclusion: These results were consistent with our pilot study, which showed no statistical difference in long-term success following silicone tube removal at 2 and 6 weeks.

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The Effect of Silicone Tube Intubation in External Dacryocystorhinostomy

Acta Medica Anatolia ◽

10.15824/actamedica.31629 ◽

2015 ◽

Vol 3 (1) ◽

pp. 1

Author(s):

Adem Gül ◽

Mustafa Duran ◽

Ertugrul Can ◽

Hilal Eser Ozturk ◽

Nursen Ariturk

Keyword(s):

Silicone Tube ◽

Silicone Tube Intubation ◽

External Dacryocystorhinostomy

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The Outcome of Silicone Intubation and Tube Removal in External Dacryocystorhinostomy Patients with Distal Canalicular Obstruction

European Journal of Ophthalmology ◽

10.5301/ejo.5000128 ◽

2012 ◽

Vol 22 (6) ◽

pp. 878-881 ◽

Cited By ~ 7

Author(s):

Ibrahim B. Buttanri ◽

Didem Serin ◽

Safak Karslioğlu ◽

Muslime Akbaba ◽

Korhan Fazil ◽

...

Keyword(s):

Tube Removal ◽

Canalicular Obstruction ◽

Silicone Intubation ◽

External Dacryocystorhinostomy

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Outcome of External Dacryocystorhinostomy with Bicanalicular Silicone Tube Stenting

Journal of Academic Research in Medicine ◽

10.5152/jarem.2014.506 ◽

2015 ◽

Vol 4 (3) ◽

pp. 88-92

Author(s):

Fadime Nuhoglu ◽

Kubra Sarici ◽

Fatma Esin Ozdemir

Keyword(s):

Silicone Tube ◽

External Dacryocystorhinostomy

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Repositioning of the Severe Prolapsed Silicone Tubes after Bicanalicular Nasal Intubation: A Novel Technique

Journal of Ophthalmology ◽

10.1155/2021/6669717 ◽

2021 ◽

Vol 2021 ◽

pp. 1-6

Author(s):

Jinjing He ◽

Jingwen Gong ◽

Qingqing Zheng ◽

Jin Jiang

Keyword(s):

Distal Part ◽

Lateral Displacement ◽

Drainage System ◽

Nasal Intubation ◽

Silicone Tube ◽

Wire Probe ◽

Nylon Suture ◽

Tube Removal ◽

Silicon Tube ◽

Lacrimal Drainage

Background. Bicanalicular nasal intubation is widely used in lacrimal drainage system surgery. Its common complication is lateral displacement or spontaneous prolapse. When the distal part of the silicone tubes cannot be seen in the nose endoscopically, either repositioning or removal could be a challenge. We developed a simple technique to reposition the severe prolapsed silicone tubes. Method. This retrospective study included 6 patients with severe prolapsed silicone tubes who had undergone bicanalicular nasal intubation between January 2017 and December 2019. We used a memory wire probe to pull a nylon suture through the lacrimal passage retrograde. Then, the nylon suture was cut into two lines. One line was coiled to the prolapsed tube and tied to another line. This nylon turned into a “lasso” to capture the silicone tube and then lock its knot. By pulling the nylon suture, the severe prolapsed silicone tube was repositioned to the nasal cavity. Results. Using this technique, we successfully repositioned severe prolapsed silicone tubes without any complication in 6 cases. Conclusions. Silicone tube reposition guiding by using a memory wire probe is an optional technique in the treatment of prolapse of silicone tubes, particularly if the distal part of the silicon tube was embedded in the lacrimal sac and cannot be seen in the nose by endoscopy. It is a feasible, minimally invasive, safe, and effective method, avoiding premature tube removal.

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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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