Mitomycin C–Enhanced Revision Endoscopic Dacryocystorhinostomy

2012 ◽  
Vol 147 (5) ◽  
pp. 937-942 ◽  
Author(s):  
Sameh M. Ragab ◽  
Hossam S. Elsherif ◽  
Emad M. Shehata ◽  
Ahmed Younes ◽  
Ahmed M. Gamea
Keyword(s):  
Mitomycin C ◽  
Controlled Study ◽  
Safe Procedure ◽  
Endoscopic Dacryocystorhinostomy ◽  
Randomized Controlled ◽  
Group I ◽  
Significant Difference ◽  
Endoscopic Dcr ◽  
Causes Of Failure

Objectives (1) To conduct an adequately powered randomized controlled trial investigating the safety and efficacy of mitomycin C–enhanced revision endoscopic dacryocystorhinostomy (DCR) and (2) to analyze causes of failure after primary endoscopic DCR. Study Design A randomized controlled study. Setting General hospital. Subjects and Methods Seventy-six revision endoscopic DCRs were randomized into 2 groups: endoscopic DCR with mitomycin (group I), where 0.5 mg/mL mitomycin C was applied for 10 minutes, and endoscopic DCR without mitomycin (group II). Follow-up settings were done to document the patient’s subjective improvement, to judge ostium patency on irrigation, and to record any complications. Results Causes of failure in the original 92 patients included canalicular obstruction (14%), small misplaced bony window (43%), very small nasolacrimal stoma due to development of synechia (23%), and complete closure of nasolacrimal stoma with tough fibrous tissue (63%). There was no significant difference between the 2 groups in subjective and objective success rates and adverse events. Group I demonstrated a significantly longer operative time and a significantly lower number of debridement sessions (mean of 1.2 vs 1.9). Conclusions Recurrent nasolacrimal duct obstruction after primary endoscopic DCR is mainly due to reclosure of the nasolacrimal stoma with synechia and fashioning of the small misplaced bony window. Mitomycin C does not increase the success rate of revision endoscopic DCR. It is a safe procedure and may be of value only in patients inaccessible to strict follow-up because it induces a better healing profile in terms of mucosal recovery, wound healing, and less need for debridement sessions.

The impact of pharmacist telephone calls after discharge on satisfaction of oncology patients: A randomized controlled study

2017 ◽  
Vol 24 (5) ◽  
pp. 359-364 ◽  
Author(s):  
Sewar S Salmany ◽  
Lujeen Ratrout ◽  
Abdallah Amireh ◽  
Randa Agha ◽  
Noor Nassar ◽  
...  
Keyword(s):  
Emergency Room ◽  
Hospital Readmissions ◽  
Randomized Controlled Study ◽  
Controlled Study ◽  
Emergency Room Visits ◽  
Oncology Patients ◽  
Randomized Controlled ◽  
Significant Difference ◽  
The Impact

Purpose The aim of the study was to determine the impact of telephone follow-up calls on satisfaction in oncology patients after hospital discharge. Method A randomized controlled study, in which patients were randomized into two groups: The experimental group with the telephone follow-up (TFU) calls (intervention) and the control group (no intervention). The telephone follow-up call was conducted within 72 h after discharge. During the call, patients were asked about their medications, namely, whether they received them, understood how to take them, and whether they developed any medication-related adverse effect. Both groups were contacted by phone two weeks later to assess their satisfaction with the discharge medication instructions and the provided pharmaceutical services, using the 5-point Likert scale. In addition, hospital records were reviewed for emergency room visits and hospital readmissions within 30 days after discharge. Results There was no difference in the percentage of patients who reported being very satisfied between both the intervention and the control groups (45% intervention vs. 48% control, P = 0.68). The mean time of the intervention phone call was 3 ± 1.7 (SD) min. During the telephone follow-up call, medication-related problems were identified in 20% of the patients. There was no significant difference in emergency room visits and hospital readmissions in the intervention group vs. control (44% vs. 53%, P = 0.123) and (37% vs. 43%, P = 0.317), respectively. Conclusion Telephone follow-up calls conducted by a pharmacist to discharged oncology patients did not improve patients' satisfaction, emergency room visits or hospital readmissions; however, they helped to identify medication-related adverse effects in the oncology patients.

scholarly journals Anatomical and Functional Evaluation of Conventional vs Inferior Endoscopic Dacryocystorhinostomy in Study Cases of Idiopathic Chronic Dacryocystitis

2017 ◽  
Vol 10 (2) ◽  
pp. 86-90
Author(s):  
Aditya Kashyap ◽  
Satisg Negi ◽  
Prem L Chauhan ◽  
Kuldeep Thakur
Keyword(s):  
Operative Time ◽  
Nasal Endoscopy ◽  
Functional Evaluation ◽  
Lacrimal Sac ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Chronic Dacryocystitis ◽  
Endoscopic Dcr ◽  
Fluorescein Dye

ABSTRACT Objective To compare the results of conventional nasal endoscopic dacryocystorhinostomy (DCR) and inferior nasal endoscopic DCR in Study cases of idiopathic chronic dacryocystitis. Materials and methods Forty patients diagnosed with idiopathic chronic dacryocystitis were divided into two groups alternately. After relevant investigations, they were subjected for endoscopic DCR by two techniques. Twenty patients underwent conventional endoscopic DCR and 20 underwent inferior endoscopic DCR under transoral pterygopalatine block and topical lignocaine (4%) with adrenaline 1:2,000. After 3 months of follow-up in the outpatient department, nasal endoscopy along with fluorescein dye disappearance test (FDDT) at 10 minutes was done. Results Ninety-five percent (19/20) of patients undergoing conventional endoscopic DCR and 90% (18/20) of patients undergoing inferior endoscopic DCR were found to have patent anatomical fistula. On FDDT, nasal endoscopy after 10 minutes revealed 84% (16/19) in group I and 94.4% (17/18) in group II with fluorescein in nasal cavity. Conclusion Present study concludes the importance of bony, tendinous, and muscular support of lacrimal sac in physiological lacrimal pump functioning and advantage of relatively new technique of inferior endoscopic DCR. Inferior endoscopic DCR is associated with less operative time as well as less local complications. How to cite this article Thakur K, Kashyap A, Negi S, Chauhan PL. Anatomical and Functional Evaluation of Conventional vs Inferior Endoscopic Dacryocystorhinostomy in Study Cases of Idiopathic Chronic Dacryocystitis. Clin Rhinol An Int J 2017;10(2):86-90.

scholarly journals Comparative Study between Negative Pressure Wound Therapy (NPWT) and Standard Moist Wound Dressing (SMWD) In Management of Diabetic Non- Ischemic Foot Ulcers

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
M G Zekri ◽  
A S Sabbour ◽  
M S Mahmoud ◽  
A F Abdelmohsen ◽  
M M Zaki
Keyword(s):  
Diabetic Foot ◽  
Wound Dressing ◽  
Hospital Admissions ◽  
Controlled Study ◽  
Foot Ulcers ◽  
P Value ◽  
Supporting Evidence ◽  
Randomized Controlled ◽  
Significant Difference

Abstract Background Diabetic Foot Ulcer(DFU) is a common complication of diabetis that has shown an increasing trend over previous decades, 15% of patients with diabetes will suffer from DFU. and approximately 20% of hospital admissions among patients with DM are the result of DFU. Standard moist wound dressing (SMWD) is considered the traditional method for management of DFU. Supporting evidence for NPWT in the treatment of diabetic foot wounds include numerous prospective and multi-centered randomized controlled trials. Aim of the Work This study aimed to compare wound outcome, limb salvage between NPWT and SMWT in management of diabetic non ischemic foot ulcers. Patients and Methods This is a randomized controlled study involving 60 patients with active diabetic foot ulcers. A computer generated randomization pattern will be used to segregate the patients into 2 groups (NPWT and SMWD groups). Primary end point of the study is to achieve full healthy granulating wound (without necrotic tissues, bone or tendon exposure and without local signs of infection). follow up included change in wound diameter, depth, up or down scaling along UTWC, wound status every 2 weeks. Results there was a statistically significant difference in rate of depth improvement for the NPWT group in 2 and 4 weeks. In six weeks follow up, the rate of depth reduction was better in NPWT group but it wasn’t statistically significant (p-value 0.14). There was a statistically significant difference in reaching full healthy granulation in 4 and 6 weeks in favor of the NPWT group compared to the SMWD, there was no statistically significant difference in number of cases reaching full healthy granulation in 8 weeks as many cases of SMWD group started to achieve full healthy granulation. Number of bed side debridement or surgical debridement was not statistically significant between the 2 groups. major amputation was seen in 4 cases of the SMWD group, and one trans-metatarsal amputation and 2 toes amputation was seen in NPWT group and none of these was statistically significant. Conclusion NPWT use in DFU provides a significant reduction in duration till reaching full healthy granulation. No significant difference was observed in ulcer related complications such as infection, cellulitis, and osteomyelitis. However, the study showed that SMWD patients had more secondary amputations than those receiving NPWT but it wasn’t statistically significant

Topical Application of Mitomycin-C in Endoscopic Dacryocystorhinostomy

2000 ◽  
Vol 14 (3) ◽  
pp. 205-208 ◽  
Author(s):  
Yookyung K. Selig ◽  
Brian S. Biesman ◽  
Elie E. Rebeiz
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Topical Application ◽  
Drainage System ◽  
Endoscopic Dacryocystorhinostomy ◽  
Small Series ◽  
Endoscopic Dcr ◽  
Intraoperative Adjuncts ◽  
Lacrimal Drainage

Endoscopic dacryocystorhinostomy (DCR) is a well-established alternative to external DCR for treatment of obstruction of the lacrimal pathway and has a success rate of up to 95% in primary cases. Despite the benefits of using an endoscopic approach, including enhanced intranasal access to the lacrimal drainage system, there still exists a significant failure rate, particularly in revision procedures. As these failures are mainly due to obstructive postoperative adhesions, intraoperative adjuncts that prevent or minimize scarring should enhance the success rate. Endoscopic DCR was performed with intraoperative topical application of mitomycin-C, an antimetabolite often used in ophthalmologic procedures to reduce scarring and formation of adhesions following surgery. The procedure was successful in 7 of 8 instances, with a follow-up of 3 to 27 months. In one procedure, obstruction recurred 10 weeks after surgery. We feel that the results of this small series are encouraging and that further studies are warranted to determine the effectiveness of mitomycin-C as an adjunct to endoscopic DCR.

scholarly journals The Effect of Acupuncture and Physiotherapy on Patients with Knee Osteoarthritis: A Randomized Controlled Study

2021 ◽  
pp. E269-E278
Author(s):  
Sevgi Gumus Atalay
Keyword(s):  
Clinical Trial ◽  
Knee Osteoarthritis ◽  
Functional Status ◽  
Acupuncture Group ◽  
Controlled Study ◽  
Randomized Controlled ◽  
Sf 36 ◽  
Tertiary Center ◽  
Significant Difference

Background: Osteoarthritis is the most prevalent form of joint disease, and the most common location is the knee. Objectives: The aim of this study was to determine the effect of acupuncture treatment and physiotherapy on pain, physical function, and quality of life (QOL) in patients with knee osteoarthritis (KOA). Study Design: This study was a prospective, randomized, controlled clinical trial. Settings: The research took place in the interventional pain unit of a tertiary center in a university hospital. Methods: One hundred patients with KOA were randomly divided into the acupuncture group and the physiotherapy group. Both treatments were given in 12 sessions over 6 weeks. Thirteen acupuncture points were selected for the knee. Local points were GB34, SP10, SP9, ST36, ST35, ST34, EX-LE2, EXLE5, EXLE4, and distal (distant) points were defined as KI3, SP6, LI4, and ST41. The Visual Analog Scale (VAS) was used to measure pain intensity. The Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and the 36-Item Short Form Health Survey (SF-36) were used to determine functional status and health-related QOL, respectively. All patients were evaluated at baseline, after the last treatment, and at the 12-week follow-up period. Results: There was no statistically significant difference between the acupuncture group and physiotherapy group in terms of pain, total WOMAC, and SF-36 levels at baseline, after treatment, and at the 12th week after treatment (P > 0.05). Both treatments significantly improved functional status (acupuncture, from 63.8 ± 20.81 to 53.72 ± 19.43; and physiotherapy, from 59.04 ± 21.49 to 52.28 ± 19.54; P < 0.05) and decreased the level of pain assessed by VAS (acupuncture, from 8.32 ± 1.61 to 5.54 ± 2.34; and physiotherapy, from 7.86 ± 1.9 to 5.68 ± 2.42; P < 0.05) at the 12-week follow-up of the study. There was no adverse advent related to therapeutic methods. Limitations: Sham or placebo control groups are lacking in this study. Conclusions: The acupuncture and physiotherapy performed twice weekly for 6 weeks have similar effects with regard to pain, functional status, and QOL. There were no significant differences between the acupuncture and physiotherapy groups in relief of pain, improved functional status, and QOL in the treatment of KOA. Both acupuncture and physiotherapy treatments were found to yield significantly superior results when compared with baseline values. Key words: Knee osteoarthritis, acupuncture, physiotherapy, randomized clinical trial

scholarly journals Percutaneous Epidural Adhesiolysis Using Inflatable Balloon Catheter and Balloon-less Catheter in Central Lumbar Spinal Stenosis with Neurogenic Claudication: A Randomized Controlled Trial

2018 ◽  
Vol 1 (21;1) ◽  
pp. 593-605
Author(s):  
Seong-Soo Choi
Keyword(s):  
Spinal Stenosis ◽  
Lumbar Spinal Stenosis ◽  
Controlled Trial ◽  
Balloon Catheter ◽  
Controlled Study ◽  
Neurogenic Claudication ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Lumbar Spinal

Background: When conventional interventional procedures fail, percutaneous epidural adhesiolysis (PEA), which has moderate evidence for successful treatment of lumbar spinal stenosis (LSS), has been recommended over surgical treatments. In a previous study, we demonstrated the efficacy of a newly developed inflatable balloon catheter for overcoming the access limitations of pre-existing catheters for patients with severe stenosis or adhesions. Objectives: This study compared the treatment response of combined PEA with balloon decompression and PEA only in patients with central LSS over 6 months of follow-up. Study Design: This study used a randomized, single-blinded, active-controlled trial design. Setting: This study took place in a single-center, academic, outpatient interventional pain management clinic. Methods: This randomized controlled study included 60 patients with refractory central LSS who suffered from chronic lower back pain and/or lumbar radicular pain. Patients failed to maintain improvement for > 1 month with epidural steroid injection or PEA using a balloon-less catheter. Patients were randomly assigned to one of 2 interventions: balloon-less (n = 30) and inflatable balloon catheter (n = 30). The Numeric Rating Scale (NRS-11), Oswestry Disability Index (ODI), Global Perceived Effect of Satisfaction (GPES), and Medication Quantification Scale III were each measured at 1, 3, and 6 months after PEA. Results: There was a significant difference between groups in NRS-11 reduction ≥ 50% (or 4 points), ODI reduction ≥ 30% (or 10 points), GPES ≥ 6 and ≥ 4 points at 6 months, and NRS11 reduction ≥ 50% (or 4 points) at 3 months after PEA (P < .03). The proportion of successful responders was higher in the balloon group than in the balloon-less group throughout the total follow-up period. Furthermore, there was a statistically significant difference between groups at 6 months after PEA (P = .035). Limitations: The results may vary according to the definition of successful response. Follow-up loss in the present study seemed to be high. Conclusion: PEA using the inflatable balloon catheter leads to significant pain reduction and functional improvement compared to PEA using the balloon-less catheter in patients with central LSS. The study protocol was approved by our institutional review board (2012-0235), and written informed consent was obtained from all patients. The trial was registered with the Clinical Research Information Service (KCT 0002093). Key words: Balloon decompression, central, chronic pain, epidural adhesiolysis, lumbar, percutaneous, radiculopathy, spinal stenosis

scholarly journals A comparative study of the results of endoscopic dacryocystorhinostomy with and without stent placement

2021 ◽  
Vol 7 (3) ◽  
pp. 525
Author(s):  
Shaili S. Shah ◽  
Shruti G. Ganvit ◽  
Kirti P. Ambani ◽  
Ashish U. Katarkar
Keyword(s):  
Stent Placement ◽  
Small Sample ◽  
Term Outcome ◽  
Long Term Outcome ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Significant Difference ◽  
Silicone Stent ◽  
Endoscopic Dcr

<p class="abstract"><strong>Background:</strong> Aim and objectives were to evaluate and compare the outcomes of endoscopic dacryocystorhinostomy (DCR) with and without silicone stenting. Surgical success was assessed both subjectively and objectively.  </p><p class="abstract"><strong>Methods:</strong> A retrospective study was conducted. Total 30 patients with acquired NLD obstruction were enrolled in the study. The patients who underwent the surgery were randomly assigned into two groups: group I: with silicone stent placement, group II: without stent placement. The patients were evaluated in terms of symptoms relief (subjective assessment) and patency of neo-ostium (objective assessment).   </p><p class="abstract"><strong>Results:</strong> In our study, success rate for patients with placement of stent was 91.66% and without stenting was 77.77%. Statistical data proved that, there was no significant difference between two groups. Endoscopic DCR with stenting had good long term outcome. It maintains patency and prevents re-closer of neo-ostium. With stenting cases cause of failure was synechiae formation and in without stenting cases causes was infection, granulation formation and stoma closer. So both cases had their own merits and demerits.</p><p class="abstract"><strong>Conclusions:</strong> The endoscopic DCR is minimally invasive and simple procedure. Patient’s discomfort, synechiae, granulations are drawbacks of stenting but stents had given good long term outcome in maintaining patency of neo-ostium. Still data proved, there was no significant difference in both groups. This was due to our small sample size. Regular follow up is necessary for better post-operative outcome and prevention of further complications. So ultimately it is surgeon choice and level of expertise decides use of stent in DCR.  </p>

scholarly journals Effect of previous botulinum neurotoxin treatment on microvascular decompression for hemifacial spasm

2013 ◽  
Vol 34 (3) ◽  
pp. E3 ◽  
Author(s):  
Xuhui Wang ◽  
Parthasarathy D. Thirumala ◽  
Aalap Shah ◽  
Paul Gardner ◽  
Miguel Habeych ◽  
...  
Keyword(s):  
Hemifacial Spasm ◽  
Microvascular Decompression ◽  
Botulinum Neurotoxin ◽  
Lateral Spread ◽  
Safe Procedure ◽  
Group I ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group Ii

Object The objective of this study was to investigate the clinical characteristics, intraoperative findings, complications, and outcomes after the first microvascular decompression (MVD) in patients with and without previous botulinum neurotoxin treatment for hemifacial spasm (HFS). Methods The authors analyzed 246 MVDs performed at the University of Pittsburgh Medical Center between January 1, 2000, and December 31, 2007. One hundred and seventy-six patients with HFS underwent botulinum neurotoxin injection treatment prior to first MVD (Group I), and 70 patients underwent their first MVD without previous botulinum neurotoxin treatment (Group II). Clinical outcome data were obtained immediately after the operation, at discharge, and at follow-up. Follow-up data were collected from 177 patients with a minimum follow-up period of 9 months (mean 54.48 ± 27.84 months). Results In 246 patients, 89.4% experienced immediate postoperative relief of spasm, 91.1% experienced relief at discharge, and 92.7% experienced relief at follow-up. There was no significant difference in outcomes and complications between Group I and Group II (p > 0.05). Preoperatively, patients in Group I had higher rates of facial weakness, tinnitus, tonus, and platysmal involvement as compared with Group II (p < 0.05). The posterior inferior cerebellar artery and vertebral artery were intraoperatively identified as the offending vessels in cases of vasculature compression in a significantly greater number of patients in Group II compared with Group I (p = 0.008 and p = 0.005, respectively, for each vessel). The lateral spread response (LSR) disappeared in 60.48% of the patients in Group I as compared with 74.19% in Group II (p > 0.05). No significant differences in complications were noted between the 2 groups. Conclusions Microvascular decompression is an effective and safe procedure for patients with HFS previously treated using botulinum neurotoxin. Intraoperative monitoring with LSR is an effective tool for evaluating adequate decompression.

scholarly journals A follow-up study of a randomized controlled study evaluating safety and efficacy of leuprorelin acetate every-3-month depot for 2 versus 3 or more years with tamoxifen for 5 years as adjuvant treatment in premenopausal patients with endocrine-responsive breast cancer

Breast Cancer ◽  
2021 ◽  
Vol 28 (3) ◽  
pp. 684-697
Author(s):  
Junichi Kurebayashi ◽  
Eiichi Shiba ◽  
Tatsuya Toyama ◽  
Hiroshi Matsumoto ◽  
Minoru Okazaki ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Disease Free Survival ◽  
Controlled Study ◽  
Efficacy And Safety ◽  
Observation Study ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Premenopausal Patients

Abstract Background Previously, we conducted the 5-year open-label, randomized controlled trial (RCT) of leuprorelin adjuvant therapy in post-operative premenopausal patients with endocrine-responsive breast cancer, which was a pilot study to investigate the optimal duration of leuprorelin treatment. Since, however, long-term outcomes became required for the adjuvant endocrine therapy, we performed this follow-up observation study. Methods Follow-up observation study was performed up to 10th year after randomization, continuing RCT to evaluate the efficacy and safety of leuprorelin every 3 months for ≥ 3 versus 2 years, with daily tamoxifen for 5 years. Primary endpoints were disease-free survival (DFS) and 2-year landmark DFS. Results Eligible patients (N = 222) were randomly assigned to receive leuprorelin for either 2 years (N = 112) or ≥ 3 years (N = 110) with tamoxifen. Leuprorelin treatment for ≥ 3 years versus 2 years provided no significant difference in DFS (HR 0.944, 95% CI 0.486–1.8392) or 2-year landmark DFS (N = 99 and 102 in 2-year and ≥ 3-year groups, HR 0.834, 0.397–1.753). In small, higher-risk subgroup (n = 17); however, 2-year landmark DFS in ≥ 3-year group was significantly longer (HR 0.095, 0.011–0.850) than that in 2-year group. The incidence of bone-related adverse events was around 5% in both groups. Conclusions Adjuvant leuprorelin treatment for ≥ 3 years with tamoxifen only showed similar efficacy and safety profiles to those for 2 years in analyses among all patients but suggested greater benefit in higher-risk patients. No new safety signal was identified for long-term leuprorelin treatment. Trial registration number Not applicable. This was an observational study.

scholarly journals Comparative Study of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy

2015 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
NK Mohindroo ◽  
Harjitpal Singh
Keyword(s):  
Comparative Study ◽  
Mitomycin C ◽  
Average Hospital ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Chronic Dacryocystitis ◽  
Endoscopic Dcr ◽  
External Dacryocystorhinostomy ◽  
Group Ii ◽  
External Dcr

ABSTRACT A prospective study on 50 cases of chronic dacryocystitis was done to see outcome of management by endoscopic dacryocystorhinostomy (DCR) in Indian population and to look for its advantages or disadvantages over external-DCR. Effect of mitomycin-C was also evaluated in endoscopic DCR cases. Dacryocystitis was diagnosed on the basis of clinical examination by doing regurgitation test and lacrimal syringing. These patients were divided into two groups: group I consisted of those 25 subjects who were planned for endonasal endoscopic DCR and group II of those 25 subjects who underwent external-DCR in ophthalmology department. Of all the cases, maximum number of cases was in the age group of 21 to 35 years, 27 (54%) cases, 88% were females and 12% were males. External-DCR required a relatively longer surgical duration of an average 65 minutes as compared to 35 minutes for endonasal DCR. Average hospital stay for patient in group I was 3 days and it was 7 days in group II. There were minimal intraoperative complications in endoscopic procedure as compared to external-DCR group. Average follow-up was 6 months. Primary success rate was 96% in both the groups. Thus, it was concluded that both the procedures represent good alternatives for the treatment of primary nasolacrimal sac or duct obstruction or chronic dacryocystitis, endoscopic DCR having advantage of less complications and less traumatic. Mitomycin-C was found to be helpful in reducing fibrosis. How to cite this article Singh H, Mohindroo NK. Comparative Study of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy. Clin Rhinol An Int J 2015;8(1):1-4.

Sign in / Sign up

Export Citation Format

Share Document