Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal canal dysplasia: a retrospective analysis in 40 children

Abstract Purpose: To investigate the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy (EN-DCR) to treat congenital nasolacrimal canal dysplasia (CNCD). Methods: Forty children (50 eyes) with congenital nasolacrimal duct obstruction (CNLDO) and lacrimal bony dysplasia, including 8 with bony atresia (10 eyes) and 32 with bony stenosis (40 eyes), were recruited in this retrospective study. Standardized EN-DCR was performed in all cases. The post-operative observations included relief of symptoms, fluorescein dye disappearance test (FDDT), syringing of lacrimal passages and anastomotic patency under nasal endoscopy. Patients were followed up for 8-18 months. Results: The standardized EN-DCR surgery had a success (cure and improvement) rate of 100%, including a cure rate of 82% and an improvement rate of 18%. The cure rate of 40 bony nasolacrimal duct stenosis was 82.5% and 10 bony nasolacrimal duct atresia was 80%. Statistical analysis showed that nether the receipt of other treatments before surgery nor the type of bony nasolacrimal duct dysplasia affected the cure rate. No significant complications were observed during the post-operative follow-up, except for four cases (4 eyes) that suffered middle turbinate and nasal mucosal adhesion and two cases with sinusitis. Conclusions: CNCD is a type of CNLDO that does not respond to conservative and conventional treatment. EN-DCR provides a safe and effective treatment for children with CNCD. It has a high success rate with a low incidence of complications.

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Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal canal dysplasia: A retrospective analysis in 40 children

10.21203/rs.2.9757/v2 ◽

2019 ◽

Author(s):

Yan-Hui Cui ◽

Cheng-Yue Zhang ◽

Wen Liu ◽

Qian Wu ◽

Gang Yu ◽

...

Keyword(s):

Middle Turbinate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Nasal Endoscopy ◽

Cure Rate ◽

Improvement Rate ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Nasolacrimal Duct Stenosis

Abstract Background: To investigate the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy (EN-DCR) to treat congenital nasolacrimal canal dysplasia (CNCD). Methods: Forty children (50 eyes) with congenital nasolacrimal duct obstruction (CNLDO) and lacrimal bony dysplasia, including 8 children with bony atresia (10 eyes) and 32 with bony stenosis (40 eyes), were recruited in this retrospective study. Standardized EN-DCR was performed in all cases. The postoperative observations included relief of symptoms, fluorescein dye disappearance test (FDDT), syringing of lacrimal passages and anastomotic patency under nasal endoscopy. Patients were followed up for 8-18 months. Results: Standardized EN-DCR surgery had a success (cure and improvement) rate of 100%, including a cure rate of 82% and an improvement rate of 18%. The cure rate among 40 cases of bony nasolacrimal duct stenosis was 82.5%, while that of 10 cases of bony nasolacrimal duct atresia was 80%. Statistical analysis showed that nether the receipt of other treatments before surgery nor the type of bony nasolacrimal duct dysplasia affected the cure rate. No significant complications were observed during postoperative follow-up except for four cases (4 eyes) that suffered middle turbinate and nasal mucosal adhesion and two cases with sinusitis. Conclusions: CNCD is a type of CNLDO that does not respond to conservative and conventional treatment. EN-DCR represents a safe and effective treatment for children with CNCD. In addition, the combination of EN-DCR with lacrimal CT scanning provides advantages over traditional lacrimal surgery in that it has a high success rate with a low incidence of complications. Key words: nasal endoscopy; endoscopic dacryocystorhinostomy (EN-DCR); children; congenital nasolacrimal duct obstruction (CNLDO); nasolacrimal canal dysplasia

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Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal canal dysplasia: A retrospective analysis in 40 children

10.21203/rs.2.9757/v3 ◽

2019 ◽

Author(s):

Yan-Hui Cui ◽

Cheng-Yue Zhang ◽

Wen Liu ◽

Qian Wu ◽

Gang Yu ◽

...

Keyword(s):

Middle Turbinate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Nasal Endoscopy ◽

Cure Rate ◽

Improvement Rate ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Nasolacrimal Duct Stenosis

Abstract Background: To investigate the therapeutic effectiveness and safety of endoscopic dacryocystorhinostomy (EN-DCR) to treat congenital nasolacrimal canal dysplasia (CNCD). Methods: Forty children (50 eyes) with congenital nasolacrimal duct obstruction (CNLDO) and lacrimal bony dysplasia, including 8 children with bony atresia (10 eyes) and 32 with bony stenosis (40 eyes), were recruited in this retrospective study. Standardized EN-DCR was performed in all cases. The postoperative observations included relief of symptoms, fluorescein dye disappearance test (FDDT), syringing of lacrimal passages and anastomotic patency under nasal endoscopy. Patients were followed up for 8-18 months. Results: Standardized EN-DCR surgery had a success (cure and improvement) rate of 100%, including a cure rate of 82% and an improvement rate of 18%. The cure rate among 40 cases of bony nasolacrimal duct stenosis was 82.5%, while that of 10 cases of bony nasolacrimal duct atresia was 80%. Statistical analysis showed that nether the receipt of other treatments before surgery nor the type of bony nasolacrimal duct dysplasia affected the cure rate. No significant complications were observed during postoperative follow-up except for four cases (4 eyes) that suffered middle turbinate and nasal mucosal adhesion and two cases with sinusitis. Conclusions: CNCD is a type of CNLDO that does not respond to conservative and conventional treatment. EN-DCR represents a safe and effective treatment for children with CNCD. In addition, the combination of EN-DCR with lacrimal CT scanning provides advantages over traditional lacrimal surgery in that it has a high success rate with a low incidence of complications. Key words: nasal endoscopy; endoscopic dacryocystorhinostomy (EN-DCR); children; congenital nasolacrimal duct obstruction (CNLDO); nasolacrimal canal dysplasia

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Attachment-oriented Endoscopic Surgical Strategy for Sinonasal Inverted Papilloma

American Journal of Rhinology ◽

10.2500/ajr.2008.22.3243 ◽

2008 ◽

Vol 22 (6) ◽

pp. 629-634 ◽

Cited By ~ 25

Author(s):

Roee Landsberg ◽

Oren Cavel ◽

Yoram Segev ◽

Avi Khafif ◽

Dan M. Fliss

Keyword(s):

Frozen Section ◽

Attachment Site ◽

Nasolacrimal Duct ◽

Surgical Strategy ◽

Nasolacrimal Duct Stenosis ◽

The Mean ◽

The One ◽

A Prospective Study ◽

Duct Stenosis

Background It is well documented that inverted papillomas (IP) have a localized attachment site. Still, instead of concentrating on the attachment site, endoscopic surgeons often perform an extended resection similar to the one achieved after external surgery. Objective Our objective was to evaluate an attachment-oriented endoscopic surgical strategy and to determine IP attachment diameter and location. Methods A prospective study was conducted. Thirty-three consecutive patients who underwent endoscopic IP excision (2001-2007) were enrolled. Thirty patients had adequate follow-up. Attachment diameters were measured in 25/33 patients. Surgery included debulking, identifying the precise mucosal attachment site, subperiosteal dissection and excision of the attachment, frozen section control, and resection/drilling of underlying bone. Results The mean measured attachment diameter (n = 25) was 8.4 ± 6 mm (range, 3-23 mm). Attachment locations included maxillary sinus (39%), ethmoid sinus (21%), nasal cavity (21%), frontal sinus (6%), sphenoid sinus (6%), lamina papyracea (3%), and cribriform plate (3%). The mean follow-up (n = 30) was 40 ± 21 months. Three patients had Krouse stage 1, 10 patients had stage 2, and 17 patients had stage 3. Nine patients had undergone previous surgeries. After attachment-oriented endoscopic surgery, three patients had persistent disease. Nasolacrimal duct stenosis was the only complication (n = 1). Conclusion Even advanced IP have small attachments. Their Identification facilitates efficacious resection with minimal morbidity.

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Efficacy of probing adjunctive with low-dose mitomycin-C irrigation for the treatment of epiphora in adults with nasolacrimal duct stenosis

Taiwan Journal of Ophthalmology ◽

10.4103/tjo.tjo_25_20 ◽

2020 ◽

Vol 0 (0) ◽

pp. 0

Author(s):

Babak Masoomian ◽

Bahram Eshraghi ◽

Golshan Latifi ◽

Hossein Esfandiari

Keyword(s):

Mitomycin C ◽

Low Dose ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Stenosis ◽

Duct Stenosis

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Nasolacrimal Duct Stenosis after Oral Capecitabine Administration

Korean Journal of Ophthalmology ◽

10.3341/kjo.2018.0113 ◽

2019 ◽

Vol 33 (1) ◽

pp. 95 ◽

Cited By ~ 1

Author(s):

Yeonji Jang ◽

Namju Kim ◽

Keun-Wook Lee ◽

Ho-Kyung Choung ◽

Sang In Khwarg

Keyword(s):

Nasolacrimal Duct ◽

Oral Capecitabine ◽

Nasolacrimal Duct Stenosis ◽

Duct Stenosis

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Assessment of Long-Term Outcomes Associated With a Lobulated Pedicled Nasal Mucosa Flap Technique for Endoscopic Dacryocystorhinostomy Without Stenting

Ear Nose & Throat Journal ◽

10.1177/0145561319900025 ◽

2020 ◽

pp. 014556131990002 ◽

Cited By ~ 1

Author(s):

Dong Wang ◽

Ping Fang ◽

Yi Zhao

Keyword(s):

Nasal Mucosa ◽

Symptom Relief ◽

Nasolacrimal Duct ◽

High Rate ◽

Long Term Outcomes ◽

Endoscopic Dacryocystorhinostomy ◽

Flap Technique ◽

Subjective Study

Objective: This study describes a surgical approach wherein a lobulated pedicled nasal mucosa flap technique was employed for endoscopic dacryocystorhinostomy (EDCR) as a means of treating nasolacrimal duct obstructions. This study also assessed the long-term outcomes of this EDCR approach when implemented without stenting. Methods: This was a retrospective study of a total of 63 patients (67 eyes) treated for nasolacrimal duct obstructions between January 2011 and November 2016. All patients had undergone ophthalmic diagnosis followed by EDCR treatment using a lobulated pedicled nasal mucosa flap without stenting. Patients were then monitored for both anatomical patency and sustained symptom relief during the follow-up period in order to assess objective and subjective study outcomes. Results: Patients were followed for a mean of 25.3 ± 1.2 months (range: 24-28 months), with a 100% anatomical patency success rate (67/67) and a 94.03% symptomatic cure rate (63/67). There were no instances of complications. Conclusions: The use of a lobulated pedicled nasal mucosa flap technique for EDCR without stenting is a straightforward, effective, and safe approach that keeps bone exposure to a minimum while offering a high rate of satisfactory outcomes, making it a procedure worthy of consideration as a means of treating patients suffering from nasolacrimal duct obstructions.

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