Dacryocystorhinostomy

1986 ◽  
Vol 95 (4) ◽  
pp. 352-355 ◽  
Author(s):  
Mirko Tos ◽  
Viggo Balle ◽  
Rud Andersen
Keyword(s):  
Nasal Cavity ◽  
Late Results ◽  
Nasolacrimal Duct ◽  
Considerable Improvement ◽  
Lacrimal Sac ◽  
Routine Procedure ◽  
Observation Period

The extranasal method of dacryocystorhinostomy, which totally incorporates the lacrimal sac into the nasal cavity, is described, and the primary and late results of this method are presented in 57 patients with chronic epiphora caused by stenosis of the nasolacrimal duct. Immediately after the operation, the results were satisfactory in all patients. At late follow-up, with a median observation period of 5 years, 80% of the patients were completely free of epiphora and 15 % had periodic epiphora, which was a considerable improvement over the preoperative condition. The described method could become a rhinologic routine procedure in patients with chronic epiphora.

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.

An Easy Method for Intraoperative Confirmation of Lacrimal Sac Patency in Endoscopic Dacryocystorhinostomy

2016 ◽  
Vol 27 (3) ◽  
pp. 379-381
Author(s):  
Fabio Pagella ◽  
Alessandro Pusateri ◽  
Elina Matti ◽  
Paolo Carena ◽  
Luis Quiroa ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Saline Solution ◽  
Lacrimal Sac ◽  
Easy Method ◽  
Continuous Irrigation ◽  
Surgical Success ◽  
Endoscopic Dacryocystorhinostomy ◽  
Common Canaliculus ◽  
The Common

Purpose Few studies have focused on the intranasal localization of the lacrimal sac during endoscopic dacryocystorhinostomy: landmarks in order to find the medial wall of the lacrimal sac have been described, but there is a lack of description of methods for the verification of the complete marsupialization of the lacrimal sac during surgery. In this report, we propose an easy and effective method for certain intraoperative identification of lacrimal sac. Methods A method in order to verify the effective marsupialization of the lacrimal sac is applied and described: to ensure that the opening of the sac in the nasal cavity is complete, the surgeon should identify the Rosenmuller valve, which is the end of the common canaliculus in the lacrimal sac. Continuous irrigation with saline solution through the inferior canaliculus can be useful to obtain a clean surgical area and to permit easy intraoperative identification of the valve. Results Between 2007 and 2015, 193 endoscopic dacryocystorhinostomies were performed in our institutions. Postoperative surgical success at last follow-up (minimum 12 months) was 93.8% (181 out of 193 of cases). No major complications were observed. Conclusions Correct and complete exposure of the lacrimal sac during surgery is crucial for a good outcome: when the opening of the common canaliculus is identified, the surgeon is assured that the sac has been correctly and completely marsupialized inside the nasal cavity.

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 A Unique Case of Primary Extranodal Non-Hodgkin's Lymphoma of the Lacrimal Sac with Extension to Ipsilateral Nasal Cavity

2014 ◽  
Vol 6 (3) ◽  
pp. 103-105
Author(s):  
Himanshu Kumar Mittal
Keyword(s):  
Nasal Cavity ◽  
Hodgkin’S Lymphoma ◽  
Rare Case ◽  
Malignant Tumors ◽  
Nasolacrimal Duct ◽  
Hodgkin's Lymphoma ◽  
Lacrimal Sac ◽  
Unique Case ◽  
Non Hodgkin’S Lymphoma ◽  
Non Hodgkin's Lymphoma

ABSTRACT The primary lacrimal sac involvement by malignant tumors is uncommon. The most commonly seen malignant tumors of the lacrimal sac are those of epithelial origin. Primary extranodal non-Hodgkin's lymphoma (PE-NHL) of the lacrimal sac is rare. We hereby present a rare case of primary non-Hodgkin's lymphoma (NHL) of the lacrimal sac with extension to the ipsilateral nasal cavity through the nasolacrimal duct. How to cite this article Mittal HK. A Unique Case of Primary Extranodal Non-Hodgkin's Lymphoma of the Lacrimal Sac with Extension to Ipsilateral Nasal Cavity. Int J Otorhinolaryngol Clin 2014;6(3):103-105.

scholarly journals Balloon dacryoplasty in the treatment of recurrent dacryocystitis

2020 ◽  
Vol 12 (4) ◽  
pp. 67-72
Author(s):  
Oleg V. Zhukov ◽  
Evgenia L. At’kova ◽  
Nikolay N. Krakhovetskiy
Keyword(s):  
Literature Review ◽  
Nasal Cavity ◽  
Medial Wall ◽  
Lacrimal Sac ◽  
Bone Window

Causes of the recurrence after dacryocystorhinostomy are errors during surgery (small size of the bone window, wrong localization of the dacryostomy (too high or too low); inadequate formation of flaps at the medial wall of the lacrimal sac and at the mucosa of the nasal cavity) or problems occurring in the follow-up period (granulation in ostium area, synechiae between the structures of the nasal cavity near the dacryostomy, canaliculi ostium obliteration). A literature review considers various methods of dacryocystitis recurrence treatment both with external and endonasal approaches. In published studies, promising results were obtained using balloon dacryoplasty in the dacryostomy area after dacryocystitis relapse.

HRA Model for Hypercholesterolemia Based on a Longitudinal Health Database

1998 ◽  
Vol 37 (02) ◽  
pp. 130-133
Author(s):  
T. Kishimoto ◽  
Y. Iida ◽  
K. Yoshida ◽  
M. Miyakawa ◽  
H. Sugimori ◽  
...  
Keyword(s):  
Total Cholesterol ◽  
Proportional Hazards ◽  
Proportional Hazards Model ◽  
Model Analysis ◽  
Serum Total Cholesterol ◽  
Hazards Model ◽  
The Mean ◽  
Health Database ◽  
Observation Period

AbstractTo evaluate the risk factors for hypercholesterolemia, we examined 4,371 subjects (3,207 males and 1,164 females) who received medical checkups more than twice at an AMHTS in Tokyo during the period from 1976 through 1991; and whose serum total cholesterol was under 250 mg/dl. The mean follow-up duration was 6.6 years. A self-registering questionnaire was administered at the time of the health checkup. The endpoint of this study was the onset of hypercholesterolemia when the level of serum total cholesterol was 250 mg/dl and over. We compared two prognosis groups (normal and hypercholesterol) in terms of age, examination findings and lifestyle. After assessing each variable, we employed Cox's proportional hazards model analysis to determine the factors related to the occurrence of hypercholesterolemia. According to proportional hazards model analysis, total cholesterol, triglyceride and smoking at the beginning, and hypertension during the observation period were selected in males; and total cholesterol at the beginning and age were selected in females to determine the factors related to the occurrence of hypercholesterolemia.

scholarly journals Ophthalmic Screening in Patients with Coronavirus Disease 2019: A Prospective Cohort Study

2021 ◽  
Vol 10 (5) ◽  
pp. 896
Author(s):  
Anthia Papazoglou ◽  
Anna Conen ◽  
Sebastian Haubitz ◽  
Markus Tschopp ◽  
Viviane J. Guignard ◽  
...  
Keyword(s):  
Animal Studies ◽  
Clinical Course ◽  
Intraocular Inflammation ◽  
Ocular Motility ◽  
Corrected Visual Acuity ◽  
Published Evidence ◽  
Laboratory Results ◽  
Minimum Angle ◽  
Observation Period

Postmortem pathological examinations, animal studies, and anecdotal reports suggest that coronavirus disease 2019 (COVID-19) could potentially affect intraocular tissue. However, published evidence is scarce and conflicting. In our study, we screened 100 eyes of 50 patients hospitalized for COVID-19. Relevant medical and ophthalmological history was assessed as well as symptoms, laboratory results, specific treatments, clinical course, and outcome. Ophthalmic exams including assessment of best corrected visual acuity (BCVA), intraocular pressure (IOP), color perception, ocular motility, ophthalmoscopy as well as optical coherence tomography (OCT) of the macula and the optic disc was performed at hospital admission and 29 to 192 days later. Of the 50 patients included, 14 (28%) were female. Median age was 64.5 (range 29–90) years. COVID-19 severity was mild in 15 (30%), severe in 30 (60%), and critical in five cases (10%). At baseline, median BCVA was 0.1 (0–1.8) Logarithm of the Minimum Angle of Resolution (LogMAR) and median IOP was 16 (8–22) mmHg. At follow-up, no relevant changes in BCVA and IOP were documented. No signs of active intraocular inflammation or optic nerve affection were found and OCT findings were widely stable during the observation period. Our findings suggest that COVID-19 does not regularly affect intraocular tissue.

The nasal cavity of two traversodontid cynodonts (Eucynodontia, Gomphodontia) from the Upper Triassic of Brazil

2021 ◽  
pp. 1-16
Author(s):  
Arymathéia Santos Franco ◽  
Rodrigo Temp Müller ◽  
Agustín G. Martinelli ◽  
Carolina A. Hoffmann ◽  
Leonardo Kerber
Keyword(s):  
Nasal Cavity ◽  
Fossil Record ◽  
Nasal Septum ◽  
Internal Surface ◽  
Nasolacrimal Duct ◽  
Upper Triassic ◽  
Late Triassic ◽  
Southern Brazil ◽  
Dorsal Region ◽  
Left And Right

Abstract Traversodontidae is a group of Triassic herbivorous/omnivorous cynodonts that represents the most diversified lineage within Cynognathia. In southern Brazil, a rich fossil record of late Middle/mid-Late Triassic cynodonts has been documented, with Exaeretodon riograndensis Abdala, Barberena, and Dornelles, 2002 and Siriusgnathus niemeyerorum Pavanatto et al., 2018 representing two abundant and well-documented traversodontids. The present study provides a comparative analysis of the morphology of the nasal cavity, nasal recesses, nasolacrimal duct, and maxillary canals of both species using computed tomography, highlighting the changes that occurred in parallel to the origin of mammaliaforms. Our results show that there were no ossified turbinals or a cribriform plate delimiting the posterior end of the nasal cavity, suggesting these structures were probably cartilaginous as in nonmammaliaform cynodonts. Both species show lateral ridges on the internal surface of the roof of the nasal cavity, but the median ridge for the attachment of a nasal septum is absent. Exaeretodon riograndensis and S. niemeyerorum show recesses on the dorsal region of the nasal cavity, which increase the volume of the nasal cavity, potentially enhancing the olfactory chamber and contributing to the sense of smell. On the lateral sides of the nasal cavity, the analyzed taxa show a well-developed maxillary recess. Although E. riograndensis and S. niemeyerorum have roughly similar nasal cavities, in the former taxon, the space between the left and right dorsal recesses of the nasal cavity is uniform along its entire extension, whereas this space narrows posteriorly in S. niemeyerorum. Finally, the nasolacrimal duct of S. niemeyerorum is more inclined anteroposteriorly than in E. riograndensis.

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