Surgery of the Lacrimal System

2011 ◽  
Author(s):  
Roger A. Dailey ◽  
Mauricio R. Chavez
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Nasolacrimal Duct ◽  
The Other ◽  
Success Rates ◽  
Lacrimal Sac ◽  
Other Hand ◽  
A Prospective Study ◽  
External Dcr

Obstruction of the tear outflow system can occur anywhere along its course from the tear lake to the inferior meatus of the nose. Surgical techniques designed to relieve this functional or complete obstruction have been available for a long time. Toti of Italy described the dacryocystorhinostomy (DCR) procedure in 1908 as a treatment modality for obstruction of the nasolacrimal duct. His technique did not make use of mucosal flaps. Dupuy-Dutemps of France, on the other hand, encouraged the use of flaps. He recommended suturing together the nasal mucosal and lacrimal sac flaps. The success rate of the operation improved dramatically. Today the external DCR procedure makes use of modifications of both of these historically described procedures. In recent years, intranasal DCR has enjoyed renewed popularity. This procedure had been performed by Lester Jones and others for years but was dropped because the success rate was 80% at best. Although the use of endoscopic techniques and laser technology has been advocated by some authorities, the success rate (approximately 70%) with relatively short-term follow-up has limited its acceptance. More recently, Javate and associates reported a series of patients undergoing endoscopic DCR with the radiofrequency Ellman unit. Their reported success rate of 90% compared favorably with a 94% success rate in 50 age-matched patients undergoing external DCR with a follow-up of 9 months. This rate also compares favorably to the present authors’ success rate of approximately 95% in uncomplicated cases undergoing external DCR and a similar rate with the endoscopic approach without use of a laser. Therefore, the laser does not appear to offer any significant advantage over more traditional intranasal approaches, and the cost may actually be a financial disincentive to its use. The benefit of mitomycin continues to be debated. You and associates performed a prospective study showing favorable long-term success rates with the use of mitomycin. On the other hand, Liu and associates performed a prospective study that demonstrated no benefit. While the DCR works well for lacrimal sac or nasolacrimal duct obstruction, it does not address obstructions of the puncta and canaliculi.

scholarly journals Functional outcome of endoscopic and external dacrocystorhinostomy in a teaching hospital

2019 ◽  
Vol 5 (2) ◽  
pp. 358
Author(s):  
Arvind Varma ◽  
Sushobhan Dasgupta
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Nasolacrimal Duct ◽  
P Value ◽  
Chi Square ◽  
Chi Square Test ◽  
Endonasal Dcr ◽  
Post Traumatic ◽  
External Dcr

<p class="abstract"><strong>Background:</strong> The objective of the study was to compare &amp; analyse the results of two different techniques of dacrocystorhinostomy (endonasal and external) in different etiological groups.</p><p class="abstract"><strong>Methods:</strong> This prospective study was carried out for nasolacrimal duct obstruction from October 2016 to October 2018 who underwent dacrocystorhinostomy by two different methods. The patient was divided into two groups one who underwent endonasal DCR (n=55) and another group who underwent external DCR (n=55). In each group they were subdivided into 3 groups on the basis of aetiology into idiopathic, post traumatic and revision cases. The results were evaluated in follow up period of 6 months. At the end of the study, decoding of the groups was done and the results were analysed statistically, using Chi Square test and student t-test, using SSPS III software. P value of less than 0.05 was considered statistically significant.</p><p class="abstract"><strong>Results:</strong> The success rate in endonasal DCR and external DCR was almost same in all the three groups (p&gt;0.05).</p><p class="abstract"><strong>Conclusions:</strong> This prospective study shows that both the methods have almost same success rate. This study also emphasises proper case selection and interdepartmental cooperation for optimum results.</p>

TREATMENT OF TRIGGER FINGERS BY INJECTION OF METHYLPREDNISOLONE ACETATE AND LIDOCAINE (DEPO-MEDROL®)

Hand Surgery ◽  
1996 ◽  
Vol 01 (02) ◽  
pp. 103-105
Author(s):  
J. Joris Hage ◽  
Jaap D.K. Munting
Keyword(s):  
Side Effects ◽  
Prospective Study ◽  
Success Rate ◽  
Adult Patients ◽  
Methylprednisolone Acetate ◽  
Short Term ◽  
Local Injections ◽  
One Year ◽  
A Prospective Study

Thirty-six adult patients with 44 trigger fingers of less than four months' duration entered a prospective study on the efficiency of treatment with local injections of a combination of corticosteroids and lidocaine. From this study it may be concluded that the short-term success rate (93%) of one to three injections of methylprednisolone and lidocaine 2% (Depo-Medrol®) is comparable to that achieved by surgical or percutaneous tenolysis. At one year of follow-up, this success rate still amounted to 86%. In our hands, this therapy is without complications or side effects.

Evaluation of Crestal Bone Loss Around Straight and Tilted Implants in Patients Rehabilitated by Immediate-Loaded Full-Arch All-on-4 or All-on-6: A Prospective Study

2019 ◽  
Vol 45 (6) ◽  
pp. 434-443
Author(s):  
Alessandro Cucchi ◽  
Elisabetta Vignudelli ◽  
Simonetta Franco ◽  
Paolo Ghensi ◽  
Luciano Malchiodi ◽  
...  
Keyword(s):  
Bone Loss ◽  
Prospective Study ◽  
Survival Rates ◽  
Immediate Loading ◽  
Success Rates ◽  
Crestal Bone Loss ◽  
Bone Level ◽  
A Prospective Study ◽  
Edentulous Jaws

The aim of this prospective study was to compare implant success rate and crestal bone loss around tilted and straight implants supporting immediate-loading full-arch rehabilitations. Twenty consecutive patients with edentulous jaws treated between June 2013 and July 2015 who satisfied all inclusion and exclusion criteria were included in the study. All patients were rehabilitated through a full-arch restoration supported by 4 or 6 immediately loaded implants. Clinical and radiographic examinations were scheduled every 12 months to evaluate implant success rates and crestal bone levels. Significant differences in crestal bone levels and success rates between straight and tilted implants were investigated by means of independent statistical analysis; differences were regarded as significant if P &lt; .05. Seventy straight and 50 tilted implants were placed to rehabilitate 14 mandibles and 12 maxillae in 20 patients. After a follow-up of 12 to 36 months, survival rate was 97.1% for straight implants and 96.0% for tilted implants; while success rates were 94.3% and 94.0%, respectively. Success and survival rates were not significantly different (P &gt; .05). Change in crestal bone level was 0.5 ± 0.4 mm for straight implants and 0.6 ± 0.4 mm for tilted implants (P &gt; .05). Straight and tilted implants seemed to have similar behavior after immediate loading rehabilitations. After functional loading, straight and tilted implants did not differ significantly in clinical outcome.

Endoscopic Dacryocystorhinostomy: Our Experience

2010 ◽  
Vol 3 (3) ◽  
pp. 131-133 ◽  
Author(s):  
Shashidhar S Suligavi ◽  
SS Chougule ◽  
SS Doddamani ◽  
CS Hiremath
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Simple Procedure ◽  
Nasolacrimal Duct ◽  
Review Of Literature ◽  
Postoperative Evaluation ◽  
Endoscopic Dacryocystorhinostomy ◽  
Endoscopic Dcr ◽  
A Prospective Study

Abstract Endoscopic dacryocystorhinostomy is an established surgery for nasolacrimal duct block. We did a prospective study to evaluate the results and advantages. All the 90 patients underwent endoscopic DCR and 26 patients had septoplasty simultaneously. Postoperative evaluation of patency and relief of symptoms was done up to 6th month. Our study concludes that endoscopic. DCR is a safe, simple procedure with a better success rate and fewer complications along with review of literature.

Laser Transcanalicular Endonasal DCR

2010 ◽  
Vol 3 (1) ◽  
pp. 23-25 ◽  
Author(s):  
Pravesh Yadav ◽  
Ravi Meher ◽  
Kavita Goyal ◽  
Virad Kumar ◽  
Aditi Chopra
Keyword(s):  
Success Rate ◽  
Failure Rate ◽  
Nasolacrimal Duct ◽  
Success Rates ◽  
Duct Obstruction ◽  
Endonasal Dcr ◽  
Endoscopic Dcr ◽  
External Dacryocystorhinostomy ◽  
Preliminary Study

Abstract Nasolacrimal duct obstruction is a common disorder which clinically manifests as epiphora. Many procedures have been described to bypass this obstruction, for example external dacryocystorhinostomy (DCR), endoscopic DCR with and without stents, Laser endoscopic DCR. Each of these procedures has its own success rates and complications. We did an analysis of all laser assisted endonasal DCR performed in our department from Feb 2006 to July 2009. In all we had operated 237 total cases out of which 203 were with normal endonasal DCR and 34 cases were Laser transcanalicular endonasal DCR (Laser DCR). Over all success rate was 92%(218 cases). In case of Laser assisted endonasal DCR the success rate was 70.3% (19 cases) with failure rate of 29.7% (8 cases) at three months follow-up. This preliminary study reveals that LASER DCR is associated with higher failure rates as compared to the normal endonasal DCR.

Tympanoplasty in children – a prospective study

1998 ◽  
Vol 112 (12) ◽  
pp. 1147-1149 ◽  
Author(s):  
Yogesh Bajaj ◽  
A. S. Bais ◽  
Bakul Mukherjee
Keyword(s):  
Prospective Study ◽  
Success Rate ◽  
Type I ◽  
Success Rates ◽  
Two Factors ◽  
Considerable Controversy ◽  
Overlay Technique ◽  
Type I Tympanoplasty ◽  
One Year ◽  
A Prospective Study

AbstractConsiderable controversy surrounds the subject of tympanoplasty in children. This prospective study looked at the results of type-I tympanoplasty in children. Forty-five children in the age group of five to 14 years were selected for the study. All these cases had a central perforation without any evidence of cholesteatoma. The ear to be operated had to be dry for at least six weeks before surgery. Type I tympanoplasty was performed on these patients with autograft temporalis fascia by either the underlay or overlay technique.The overall success rates in 45 operations evaluated one year post-operatively was 91.1 per cent. The age of the patient had no influence on the success rate. The two factors which adversely influenced the success rate were the presence of near total perforation and bilateral perforations.It was concluded that type-I tympanoplasty has a good chance of success in children regardless of age.

scholarly journals BIODEGRADABLE BILIARY STENTS: A NEW APPROACH FOR THE MANAGEMENT OF HEPATICOJEJUNOSTOMY STRICTURES FOLLOWING BILE DUCT INJURY. PROSPECTIVE STUDY

2016 ◽  
Vol 29 (2) ◽  
pp. 112-116 ◽  
Author(s):  
Mariano E. GIMÉNEZ ◽  
Mariano PALERMO ◽  
Eduardo HOUGHTON ◽  
Pablo ACQUAFRESCA ◽  
Caetano FINGER ◽  
...  
Keyword(s):  
Bile Duct ◽  
Prospective Study ◽  
Stent Placement ◽  
Balloon Dilation ◽  
Success Rates ◽  
Biliary Stents ◽  
Common Procedure ◽  
Biodegradable Stents ◽  
A Prospective Study

ABSTRACT Background: Once a biliary injury has occurred, repair is done by a hepaticojejunostomy. The most common procedure is to perform a dilatation with balloon with a success of 70 %. Success rates range using biodegradable stents is from 85% to 95%. Biodegradable biliary stents should change the treatment of this complication. Aim: To investigate the use of biodegradable stents in a group of patients with hepaticojejunonostomy strictures. Methods: In a prospective study 16 biodegradable stents were placed in 13 patients with hepaticojejunostomy strictures secondary to bile duct repair of a biliary surgical injury. Average age was 38.7 years (23-67), nine were female and four male. All cases had a percutaneous drainage before at the time of biodegradable stent placement. Results: In one case, temporary haemobilia was present requiring blood transfusion. In another, pain after stent placement required intravenous medication. In the other 11 patients, hospital discharge was the next morning following stent placement. During the patient´s follow-up, none presented symptoms during the first nine months. One patient presented significant alkaline phosphatase elevation and stricture recurrence was confirmed. One case had recurrence of cholangitis 11 months after the stent placement. 84.6% continued asymptomatic with a mean follow-up of 20 months. Conclusion: The placement of biodegradable stents is a safe and feasible technique. Was not observed strictures caused by the stent or its degradation. It could substitute balloon dilation in strictures of hepaticojejunostomy.

Revision Dacryocystorhinostomy: A Comparison of Endoscopic and External Techniques

2005 ◽  
Vol 19 (3) ◽  
pp. 322-325 ◽  
Author(s):  
Angelo Tsirbas ◽  
Garry Davis ◽  
Peter J. Wormald
Keyword(s):  
Success Rate ◽  
Complete Relief ◽  
Fisher Exact Test ◽  
Success Rates ◽  
Exact Test ◽  
Endoscopic Techniques ◽  
Canalicular Obstruction ◽  
Endoscopic Dcr ◽  
External Dcr

Background Success rates for revision dacryocystorhinostomy (DCR) are lower than primary DCR. Scarring of the sac may limit the ability of the surgeon to achieve good nasal and lacrimal mucosa apposition. This study evaluates the comparative success rates of the external and endoscopic techniques for revision DCR. Methods Seventeen consecutive revision endoscopic DCRs (average age, 60.9 years) and 13 revision external DCRs (average age, 65.1years) performed from January 1999 to December 2000 performed by separate surgeons were entered into the study. Patients with functional nasolacrimal and canalicular obstruction were excluded. The average follow-up was 11.1 months for the endoscopic DCR group and 10 months for the external DCR group. Results A successful DCR required complete relief of symptoms and an endoscopically determined anatomic patency of the nasolacrimal system. Revision endoscopic DCR surgery was successful in 76.5% of cases (13 of 17 cases) and external DCR surgery was successful in 84.6% (11 of 13 cases). This difference was not statistically significant. (p = 0.64, Fisher exact test with a two-tailed probability). Conclusion Revision endoscopic DCR has a success rate of 76.5%, which compares favorably with that of the revision external DCR (84.6%).

Endoscopic transnasal dacryocystorhinostomy with nasal mucosal and posterior lacrimal sac flap

2008 ◽  
Vol 123 (3) ◽  
pp. 320-326 ◽  
Author(s):  
N Sonkhya ◽  
P Mishra
Keyword(s):  
Success Rate ◽  
Symptom Relief ◽  
Case Series ◽  
Cost Effective ◽  
Nasolacrimal Duct ◽  
Sinus Surgery ◽  
Lacrimal Sac ◽  
Endoscopic Endonasal ◽  
Lost To Follow Up

AbstractObjective:To describe a new endonasal dacryocystorhinostomy technique and to assess its efficacy.Design:Prospective, non-randomised, interventional case series.Patients and methods:Patients with primary nasolacrimal duct obstruction were included. A prospective series of 226 consecutive endoscopic transnasal dacryocystorhinostomies performed between January 2003 and December 2006 were entered into the study. Patients who had undergone previous lacrimal surgery were excluded. The surgical technique involved the creation of nasal mucosal and large posterior lacrimal flaps at the medial lacrimal sac wall. The two flaps were placed in close apposition. The technique also involved creation of a large bony ostium.Main outcome measures:Success was defined as the resolution of symptoms, or unobstructed lacrimal irrigation and endoscopic visualisation of a patent rhinostomy.Results:A total of 226 consecutive endoscopic transnasal dacryocystorhinostomy procedures performed between January 2003 and December 2006 were reviewed. The main presentation was with epiphora (95 per cent) and/or mucocele (13 per cent). Septoplasty was performed in 36 per cent of cases at the time of surgery. In 18 per cent of cases, endoscopic sinus surgery was also added to the procedure. The follow-up period ranged from six months to two years. Of the 226 patients, eight were lost to follow up and were thus excluded from the series. The procedure achieved a 92 per cent success rate, in terms of symptom relief and anatomical success.Conclusion:The described technique of endoscopic endonasal dacryocystorhinostomy had a success rate comparable to that of external dacryocystorhinostomy. The procedure is simple and cost-effective because it does not require sophisticated equipment such as lasers, optical fibres, silicone stents or a microdebrider.

scholarly journals The effect of the Thai “Eye Drop Guide” on success rate of eye drop self-instillation by glaucoma patients

2014 ◽  
Vol 8 (2) ◽  
pp. 221-227 ◽  
Author(s):  
Darin Sakiyalak ◽  
Krissana Maneephagaphun ◽  
Ankana Metheetrairat ◽  
Ngamkae Ruangvaravate ◽  
Naris Kitnarong
Keyword(s):  
Success Rate ◽  
Older Age ◽  
The Other ◽  
Eye Drops ◽  
Success Rates ◽  
Chronic Glaucoma ◽  
Traditional Technique ◽  
Other Hand ◽  
Inappropriate Treatment ◽  
Practice Period

Abstract Background: Noncompliance can mislead clinicians regarding the efficacy of therapy and result in more aggressive, but inappropriate treatment. Improper techniques used for eye drop instillation frequently occurs in chronic glaucoma patients. The Thai Eye Drop Guide (EDG) device has been developed to ensure precise instillation. However, whether the EDG is more effective than the traditional technique when careful instructions for both techniques are given is still unknown. Objective: To compare success rates of eye drop self-instillation by chronic glaucoma patients using a traditional technique and the EDG when careful instructions for both are given. Methods: Fifty-nine chronic glaucoma patients were instructed to instill eye drops using the EDG or a traditional technique in a randomized sequence. A two week practice period was assigned before groups were crossed-over. The instillation performance was VDO recorded after each practice period. Three criteria of success: time taken to instill an eye drop into the eye; instillation of only one drop; and without the bottle tip touching lids, lashes, periocular tissues, or the other hand, were scored by three independent readers from video-records. The readers were blinded to the sequence to which the patients were randomized. Results: There were no significant differences in success rates between the EDG and traditional technique (61.0% and 66.1% respectively, p = 0.607) and the number of drops dispensed per application (median of 1 drop in both groups, p = 0.89). The time taken to instill eye drops with the EDG was significantly longer than using the traditional technique (median of 19 and 9 s respectively, p < 0.001). Older age (p = 0.049, OR 4.23) and more education (p = 0.025, OR 0.19) were found to be significantly associated with failure of the EDG. Conclusion: EDG is not more effective than a traditional technique in terms of improving dispensing accuracy and decreasing the drops dispensed per application even when careful instructions are given. The results suggest that, if good instructions are provided, experienced glaucoma patients can improve their eye drop instillation performance.

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