Concomitant nasal procedures in endoscopic dacryocystorhinostomy

Dacryocystorhinostomy (DCR) is the preferred treatment for lacrimal duct blockage. Endoscopic DCR has been practised increasingly in recent years as it avoids a facial scar and can be performed as a day procedure. Recent improvements in endonasal surgical techniqueled to success rates of up to 90per cent. However, the endonasal approach often requires septalor turbinate surgery to optimze access to the lacrimal area.The incidence of concomitant procedures was investigated in 256 patients undergoing endonasal nonlaser DCR. In this study 55 out of 256 patients (21.5 per cent) required additional endonasal procedures to improve access to the lacrimal area.It is therefore advisable that otolaryngologists are involved in this procedure.

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Endoscopic Dacryocystorhinostomy With Ologen Implant

10.21203/rs.3.rs-1178929/v1 ◽

2022 ◽

Author(s):

Ali Abd El-Hakam Ali El-Hayes ◽

Ashraf Ali Eldemerdash ◽

Sameh Saad Mandour ◽

Hesham Mohamed El Mazar

Keyword(s):

The Other ◽

University Hospital ◽

Controlled Study ◽

Inflammatory Disorder ◽

Success Rates ◽

Endoscopic Dacryocystorhinostomy ◽

Post Surgery ◽

Implant Complications ◽

Silicon Tube ◽

Endoscopic Dcr

Abstract Objective: To compare the effectiveness of endoscopic dacryocystorhinostomy with ologen implant versus endoscopic dacryocystorhinostomy with silicon tube implantation.Background: Chronic dacryocystitis is an inflammatory disorder of the lacrimal sac that is mostly accompanied by partial or total nasolacrimal duct obstruction. Watering and discharge are the most common symptoms, however some cases can escalate to serious ocular and extraocular complications. It can result in severe ocular morbidity and loss of productivity at work, as it can temporarily obscure vision, prevent a person from concentrating on their task, and be socially uncomfortable. The goal of this research is to find a way to reduce recurrence after DCR surgery.Methods: We conducted a prospective controlled study to evaluate effectiveness of endoscopic dacryocystorhinostomy with ologen implant versus endoscopic dacryocystorhinostomy with silicon tube implantation. A total of 40 patients underwent primary endoscopic DCR surgery in Menoufia University Hospital from march 2020 till march 2021. A total of 20 cases did endoscopic DCR using ologen implant (group A) and the other 20 cases did endoscopic DCR using silicon tube (group B). Results: The success rate, which was evaluated by MUNK score and syringing test, was compared between both groups also rate of complications like epistaxis, implant complications and post surgery synechiae was compared. Success rates was 75% in ologen group and 85%in the other group. Epistaxis, infection and post sugery synechiae were statistically in significant between the two groups but implant complications was more in ologen group than the other group.Conclusion: Endoscopic DCR with ologen implantation is not superior to endoscopic DCR with silicon stenting due to the challenging ologen implantation procedure and the high cost relative to silicon stenting.

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Endonasal endoscopic dacryocystorhinostomy in Misrata central hospital, Libya

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20180692 ◽

2018 ◽

Vol 4 (2) ◽

pp. 317

Author(s):

Abdussalam M. Jahan ◽

Yousef M. Eldanfur ◽

Abdulhakim Ben Ghuzi

Keyword(s):

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Success Rates ◽

Central Hospital ◽

Endoscopic Endonasal ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Endoscopic Dcr ◽

One Year ◽

The Right

Background: Dacryocystorhinostomy (DCR) is a surgical procedure performed for the relief of nasolacrimal duct obstruction (NLDO). This procedure involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. It can be performed externally or endoscopically. The aim of this study is to evaluate the success rates and complications of endoscopic dacryocystorhinostomy in Misurata Central Hospital. Methods: Prospective study includes 30 patients admitted to the ENT-Department, Misrata Central Hospital over a period of one year, starting from April 2016 to March 2017. They underwent endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction. Results: Thirty patients were included in the study. Their age ranged from 11-60 years, with mean age of 33 years. Most of the patients were in the age range of 31 to 50 years. There were 24 (80%) females and 6 (20%) males. The most common complaint of patients before surgery was epiphora. There was more obstruction on left side -21 (70%) than on the right side-9 (30%). Bilateral involvement was not seen. Three patients (10%) were required septoplasty during the endoscopic DCR procedure. Twenty four out of thirty (80%) patients had complete resolution. There were no any significant major complications observed in any patient in our study. Conclusions: Endoscopic DCR is safe, successful procedure for the treatment of nasolacrimal duct obstruction and has several advantages over conventional external approach.

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Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

Journal of Clinical Medicine ◽

10.3390/jcm10102161 ◽

2021 ◽

Vol 10 (10) ◽

pp. 2161

Author(s):

Jae Yun Sung ◽

Ju Mi Kim ◽

Jae Yul Hwang ◽

Kyoung Nam Kim ◽

Jae Young Kim ◽

...

Keyword(s):

Subgroup Analysis ◽

Surgical Outcomes ◽

Timing Of Surgery ◽

Secondary Outcome ◽

Control Group ◽

Optimal Timing ◽

Secondary Outcome Measure ◽

Success Rates ◽

Endoscopic Dacryocystorhinostomy ◽

And Gender

Purpose: To evaluate the surgical outcomes of primary early endoscopic dacryocystorhinostomy (EnDCR) in acute dacryocystitis (AD) and to determine the optimal timing for surgery. Methods: A retrospective review of medical records was performed on consecutive patients who underwent primary early EnDCR (within 1 week) for AD between May 2010 and June 2020 (AD group) and an age- and gender-matched control group of NLDO patients who underwent EnDCR (non-AD group). The primary outcome measures were the surgical outcomes at the final follow-up examination. The secondary outcome measure was the clinical course of AD patients. Subgroup analysis was performed to determine the optimal timing of surgery by comparing the outcomes of very early EnDCR (within 3 days) and those of early EnDCR (between 4 and 7 days). Results: Forty-one patients were included in the AD group and 82 patients in the non-AD group. The anatomical and functional success rates were 87.8% and 82.9% in the AD group, and 91.5% and 84.1% in the non-AD group, which were not significantly different between the two groups (p = 0.532 and p = 0.863). In the AD group, the mean times for pain relief and resolution of swelling after surgery were 2.4 and 6.5 days after surgery, respectively. In the subgroup analysis according to the timing of surgery, the time for symptom resolution after diagnosis, the length of hospital stays, and the duration of antibiotic treatments were significantly shorter after very early EnDCR (all ps < 0.05), whereas the surgical outcomes were not different between the two groups (p = 1.000). Conclusions: Primary early EnDCR is a safe and effective procedure for the treatment of AD. In particular, very early EnDCR performed within 3 days leads to faster recovery and shortens the course of antibiotic treatment.

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Stent technique for endoscopic dacryocystorhinostomy – Our expertise

Romanian Journal of Rhinology ◽

10.1515/rjr-2016-0003 ◽

2016 ◽

Vol 6 (21) ◽

pp. 23-27

Author(s):

Vlad Budu ◽

Tatiana Decuseara ◽

Bogdan Mocanu ◽

Raluca Baican ◽

Mihai Tusaliu ◽

...

Keyword(s):

Success Rate ◽

Lacrimal Sac ◽

Lacrimal Duct ◽

Bottom Edge ◽

Duct Obstruction ◽

Endoscopic Dacryocystorhinostomy ◽

Lacrimal Apparatus ◽

The Mean ◽

Surgery Department ◽

The Ideal

Abstract BACKGROUND. Endoscopic dacryocystorhinostomy is known to be the ideal treatment for saccal and postsaccal stenosis of the lacrimal apparatus. Following this surgery, an important inconvenient would be the stenosis of the created ostium with consecutive epiphora. MATERIAL AND METHODS. 20 patients with chronic unilateral lacrimal duct obstruction were operated in “Prof. Dr. D. Hociota” Institute of Phono-Audiology and Functional ENT Surgery, Department I, between January 2015 and July 2015. After creating the dacryocystorhinostoma, a stent was inserted transnasally to the bottom edge of the lacrimal sac and positioned to the bony margin of the ostium. Stents used varied in size from 1 to 3 mm in diameter. We followed-up our patients at 2 weeks and 1, 3, 6 months, assessing the symptoms of the lacrimal apparatus, especially the epiphora. RESULTS. The mean age of patients varied between 31 and 65. Most of our patients were women (n=14). In a total number of 16 patients epiphora disappeared, it decreased in 2 patients, and persisted in 2 patients. There were two patients with no changes who have spontaneously eliminated the stent 2 or 3 days after the surgery. The most widely used stent size was 3 mm diameter, with a success rate of 90%. CONCLUSION. The endoscopic approach may be an effective procedure in patients with pathologies of the lacrimal apparatus. In order to achieve an efficient result, both a preoperative rigorous preparation and also postoperative medical care are necessary. In conclusion, ostium stenting represents a better way to ensure a longer period of maintaining the permeability of the lacrimal apparatus.

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A New Modification in Endoscopic Endonasal Dacryocystorhi̇nostomy Scopy-Guided Approach

10.21203/rs.3.rs-307225/v1 ◽

2021 ◽

Author(s):

Akalın İrfan ◽

Ahmet Kalkışım ◽

Hasan Gündoğdu

Keyword(s):

Surgical Intervention ◽

Nasolacrimal Duct ◽

Silicone Tube ◽

Endoscopic Endonasal ◽

New Approach ◽

Surgical Success ◽

Endoscopic Dacryocystorhinostomy ◽

Significant Difference ◽

Endoscopic Dcr ◽

Anatomical Success

Abstract PurposeTo compare and assess classic endoscopic dacryocystorhinostomy (cEDCR) and scopy-guided endoscopic dacryocystorhinostomy (sEDCR) which is a new approach we developed in cases of primary nasolacrimal duct obstruction (PNLDO).MethodsFifty eyes (7 in both eyes) of 43 patients who applied with epiphora and underwent endoscopic DCR and silicone tube implantation between 2015 and 2019 were prospectively studied. cEDCR was performed on 26 of 50 eyes, and sEDCR was performed on 24 of 50 eyes. In sEDCR application, 5 cc non-ionizing opaque material was injected after punctum dilatation, lateral oblique radiographs were taken from the obstructed side with C-arm scope, and the size and location of the lacrimal sac were made visible. Thence, the most appropriate part of the passage was visualized, and surgical intervention was made through this point. Patients were followed in day 1, week 1, 3rd and 6rd mounth. Functional success was assessed according to Munk scoring, and anatomic success was assessed with nasolacrimal lavage. Two groups were compared according to surgical success, time, and complications.ResultsMean age of the cases were 47.85 (±11.8) in the cEDCR group and 54.29 (±16.23) in the sEDCR group. Female and male gender distribution was 21 (80.8%) - 5 (19.2%) for cEDCR and 15 (62.5%) - 8 (37.5%) for sEDCR, respectively. Functional success was spotted as 92.3% in the cEDCR group and 95.8% in the sEDCR group (p:1.0); anatomical success was spotted as 88.5% in the cEDCR group, and 95.8% in the sEDCR group (p:0,611). There was no significant difference between two groups. Mean surgery time was 43 minutes in the cEDCR group and 48 minutes in the EDCR group. Complications were minor and rare (p >0.05). ConclusionAs we are aware of that, our study is the first in literature in which scopy is used in endoscopic DCR. In our study, the sEDCR approach is assessed as a useful modification which improves success and facilitates surgery.

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Mitomycin C–Enhanced Revision Endoscopic Dacryocystorhinostomy

Otolaryngology ◽

10.1177/0194599812450280 ◽

2012 ◽

Vol 147 (5) ◽

pp. 937-942 ◽

Cited By ~ 25

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.

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Successes rate of endoscopic dacryocystorhinostomy at KMC

Kathmandu University Medical Journal ◽

10.3126/kumj.v8i2.3557 ◽

1970 ◽

Vol 8 (2) ◽

pp. 195-198 ◽

Cited By ~ 2

Author(s):

S Shrestha ◽

PK Kafle ◽

S Pokhrel ◽

M Maharjan ◽

KC Toran

Keyword(s):

Success Rate ◽

Symptomatic Relief ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Sinus Surgery ◽

Duct Obstruction ◽

Complete Cure ◽

Endoscopic Dacryocystorhinostomy ◽

Endoscopic Dcr ◽

Sac Syringing

Background: Nasolacrimal duct obstruction is a common problem which can be corrected by dacryocystorhinostomy (DCR). The gold standard treatment for this is DCR operation through an external approach. Development of endoscopic sinus surgery and endoscopic DCR performed through intranasal route is a major recent development in this field. Objectives: The aim of this study is to find out the success rate of endoscopic dacryocystorhinostomy without silicon stent intubation within the period of six month following surgery. Materials and methods: A prospective study was done on 26 patients with obstruction of the nasolacrimal duct referred from eye out-patient department to ENT OPD during one year period from 2008 to 2009. All the cases had undergone endoscopic DCR operation which was regularly followed up for a period of six months. Postoperative patency of ostium was checked by sac syringing and endoscopic visualisation of ostium in the nasal cavity. The success of surgery was categorised as: complete cure, partial cure and no improvement depending upon symptomatic relief and clinical examination such as sac syringing and endoscopic examination following surgery. Result: In six months' follow-up, 22 (84.5%) out of 26 patients had achieved the complete cure and 4 patients (15.5%) continued to have persistent epiphora. Conclusion: Endoscopic DCR is a beneficial procedure for nasolacrimal duct obstruction with no external scar on face and less bleeding. The success rate is as good as external DCR. Key words: Nasolacrimal duct; Epiphora; Rigid nasal endoscope; Endoscopic Dacryocystorhinostomy DOI: 10.3126/kumj.v8i2.3557 Kathmandu University Medical Journal (2010), Vol. 8, No. 2, Issue 30, 195-198

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Comparing Outcomes of the Standard Technique of Endoscopic DCR with Its Modifications: A Retrospective Analysis

Otolaryngology ◽

10.1177/0194599818813123 ◽

2018 ◽

Vol 160 (2) ◽

pp. 347-354 ◽

Cited By ~ 6

Author(s):

Subodh Kumar ◽

Awadhesh Kumar Mishra ◽

Ashwani Sethi ◽

Ajay Mallick ◽

Nidhi Maggon ◽

...

Keyword(s):

Retrospective Analysis ◽

Preoperative Evaluation ◽

Tertiary Care ◽

Operating Time ◽

Standard Technique ◽

Success Rates ◽

Retrospective Case ◽

Case Record ◽

Significant Difference ◽

Endoscopic Dcr

Objective To compare the outcomes of various techniques of endoscopic dacryocystorhinostomy (DCR). Study Design Retrospective case record analysis. Settings Tertiary care referral center. Subject and Methods Retrospective analysis of case records was carried out pertaining to the period from January 1996 to September 2017 with respect to patients who had undergone endoscopic DCR with either the standard technique or one of its modifications. Case notes showing well-documented preoperative evaluation, operative details, postoperative assessment, and minimum 6-month follow-up were considered. The outcomes were measured on the basis of patients’ postoperative symptoms, clinical examination, and sac-syringing results. Results A total of 423 patients were included in the study. Of these, 169 underwent standard endoscopic DCR; 87, endoscopic DCR with stent; 19, endoscopic DCR with mitomycin C; 62, powered DCR; 29, laser-assisted DCR; and 57, balloon DCR. There was no statistically significant difference in success rates, recurrences, or complications of various techniques at 3 or 6 months. Mean operating time was lowest for balloon DCR (mean ± SD, 27.1 ± 3.1 minutes), followed by standard endoscopic DCR (38.2 ± 3.6 minutes; P = .001). Conclusion Standard endoscopic DCR and its more sophisticated modifications were equally effective and safe in managing distal nasolacrimal drainage obstruction. Balloon DCR, followed by standard endoscopic DCR, was significantly faster than other techniques.

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Role of Silicone Stenting in Endoscopic Dacryocystorhinostomy: A Comparative Study

International Journal of Advanced and Integrated Medical Sciences ◽

10.5005/jp-journals-10050-0002 ◽

2016 ◽

Vol 1 (1) ◽

pp. 4-6 ◽

Cited By ~ 2

Author(s):

Shahzad Ahmad ◽

Bhawana Pant

Keyword(s):

Comparative Study ◽

Nasolacrimal Duct ◽

Endoscopic Dacryocystorhinostomy ◽

Medical College ◽

Randomized Design ◽

Silicone Stent ◽

Foreign Body Reactions ◽

Endoscopic Dcr ◽

The Cost

ABSTRACT Objective To evaluate the role of using silicone stent in endoscopic dacryocystorhinostomy (DCR) and compare the results with endoscopic DCR without silicone stenting. Design Prospective study, interventional type, randomized design and comparative analysis. Materials and methods The study was done in Department of Otorhinolaryngology, Government Medical College and Dr Susheela Tiwari Hospital, Haldwani, Uttarakhand. We included 30 patients in the study presenting with epiphora with or without mucocele and congenital cases of dacryocystitis and nasolacrimal duct (NLD) blockage were included in the study. All patients were divided into two groups. First one undergoing endoscopic DCR and silicone stent was used in all cases and second one underwent endoscopic DCR and no stent was used. Postoperative assessment was carried out at the end of 1st, 3rd, 6th and 10th week and the role of silicone stent was subjected to compare. Result Use of silicone stent was not improving the results and risk of failure of the surgery had increased with stent due to granulation formation in the lacrimal sac region. Apart from that, foreign body reactions in the form of irritation, pain were seen with stent. It also added the cost of surgery without giving much benefit to the patient. How to cite this article Ahmad S, Pant B. Role of Silicone Stenting in Endoscopic Dacryocystorhinostomy: A Comparative Study. Int J Adv Integ Med Sci 2016;1(1):4-6.

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Role of silicone stenting in endoscopic dacryocystorhinostomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20200136 ◽

2020 ◽

Vol 6 (2) ◽

pp. 248

Author(s):

Abdussalam M. Jahan ◽

Yousef M. Eldanfur ◽

Abdulhakim B. Ghuzi

Keyword(s):

Success Rate ◽

Medical Center ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

P Value ◽

Success Rates ◽

Duct Obstruction ◽

Significant Difference ◽

Silicone Stent ◽

Endoscopic Dcr

Background: Dacryocystorhinostomy (DCR) is a surgical procedure performed to relief nasolacrimal duct obstruction, which involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. Closure of the rhinostomy opening was considered a major factor for surgical failure. Use of silicone stent in endoscopic DCR to improve the success rate of the operation have been tried by many surgeons. In this study we assess the success rates of endoscopic DCR with and without silicone stents.Methods: Prospective study includes 30 patients were operated in the Department of ENT, Misrata Medical Center, from April 2017 to March 2018. They underwent endonasal endoscopic DCR for primary acquired nasolacrimal duct obstruction. These patients were randomly divided in two groups: A and B with 15 patients in each group. The group A patients underwent endoscopic DCR with silicone stent and group B patients underwent endoscopic DCR without stent. The results were statistically analyzed by chi-square test. Results: 30 patients were included in this study, their age ranged from 17 to 60 years, complaining of epiphora, 24 (80%) were females and 6 (20%) were males. The success rate was higher in patients with silicone stent (93.33%) as compared to patients without silicone stent (86.67%) but this difference in the results is not statistically significant (As p value is 0.542 which is >0.05).Conclusions: Endoscopic DCR is safe, successful procedure for treatment of nasolacrimal duct obstruction and there was no significant difference in the success rates of performing endonasal DCR with silicone or without silicone stents.

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