scholarly journals Evaluation of the results endonasal dacrocystorhinostomy in patients with DCR

2017 ◽  
Vol 3 (2) ◽  
pp. 184
Author(s):  
Mukund Vaghela ◽  
Alpesh Patel ◽  
Vaibhav Patel ◽  
Ankur Dhanani
Keyword(s):  
Postoperative Complications ◽  
Lacrimal Sac ◽  
Endoscopic Endonasal ◽  
Lacrimal System ◽  
Lacrimal Drainage

<p class="abstract"><strong>Background:</strong> <span lang="EN-IN">Dacrocystitis refers to a series of clinical entities characterized by inflammation of lacrimal sac which leads to obstruction at the level of drainage of lacrimal system. Owing to the initial encouraging results and simplicity of the operation, it is decided that all symptomatic patients with lacrimal drainage obstruction would be treated initially by endoscopic endonasal dacrocystorhinostomy method, irrespective of the level of obstruction. </span></p><p class="abstract"><strong>Methods:</strong> <span lang="EN-IN">A total 50 patients were included in the study over a period of 3-4 months. They were subjected to endonasal dacrocystorhinostomy and were evaluated for postoperative complications.  </span></p><p class="abstract"><strong>Results:</strong> <span lang="EN-IN">Very few complications were seen postoperatively suggesting that this newer technique may be useful. </span></p><p class="abstract"><strong>Conclusions:</strong> <span lang="EN-IN">Endonasal dacrocystorhinostomy may prove better in coming years.</span></p>

The Relationship of Lateral Osteotomies in Rhinoplasty to the Lacrimal Drainage System

1986 ◽  
Vol 94 (3) ◽  
pp. 362-367 ◽  
Author(s):  
J. Regan Thomas ◽  
Nancy Griner
Keyword(s):  
Drainage System ◽  
Osteotomy Site ◽  
Lacrimal Sac ◽  
Lacrimal Duct ◽  
Lacrimal Drainage System ◽  
Lacrimal System ◽  
Resident Surgeon ◽  
Relationship Of ◽  
The Relationship ◽  
Lacrimal Drainage

Damage to the lacrimal drainage system is a potentially complicating factor in rhinoplasty utilizing lateral osteotomies. The authors present data from osteotomies performed on a series of fresh cadavers. Following completion of the osteotomies, the lacrimal sac and nasal lacrimal ducts were Identified and cannulated. Soft tissue was dissected to demonstrate the osteotomy site. The specimen was inspected to delineate involvement (if any) of the lacrimal duct or sac. The proximity of the osteotomy site to the lacrimal drainage apparatus components was measured in each specimen. Various parameters were observed, including the effect of curved vs. straight osteotomes, guarded vs. unguarded osteotomes, and the effect of various widths of osteotomes. Likewise, the degree of risk to the lacrimal system was evaluated, and the technique of the novice and resident surgeon was compared to that of the experienced rhinoplastic surgeon. A low, curved osteotomy, performed with a sharp osteotome without subperiosteal tunnels, provides the safest maneuver. Lateral osteotomies, properly performed, prove to be an unusual cause of lacrimal drainage dysfunction.

Dacryocystorhinostomy Utilizing an Anterior Lacrimal Sac Flap to Periosteum Technique

1979 ◽  
Vol 87 (2) ◽  
pp. 174-182 ◽  
Author(s):  
G. Richard Holt ◽  
Jean Edwards Holt ◽  
Edwin A. Cortez
Keyword(s):  
Effective Treatment ◽  
Nasal Mucosa ◽  
Drainage System ◽  
Lacrimal Sac ◽  
Pedicle Flap ◽  
Lacrimal System ◽  
Common Causes ◽  
Nasal Trauma ◽  
Anterior Lacrimal Crest ◽  
Lacrimal Drainage

Dacryocystorhinostomy is used in the effective treatment of epiphora secondary to obstruction of the lacrimal drainage system. Common causes of obstruction include canalicular disruption, lacrimal sac fibrosis, and external and internal nasal trauma. Most techniques of dacryocystorhinostomy attempt to suture the lacrimal sac mucosa to the nasal mucosa. At best this is technically difficult, and the mucosa frequently tears. A technique is presented using an anteriorly based lacrimal sac pedicle flap sutured to the periosteum of the anterior lacrimal crest. The sutured flap is quite strong, and the procedure is technically simpler than others. A brief description of the causes of lacrimal obstruction is given. The Jones primary and secondary dye tests for lacrimal system patency are reviewed.

Hammer-Chisel Technique in Endoscopic Dacryocystorhinostomy

2003 ◽  
Vol 112 (5) ◽  
pp. 444-449 ◽  
Author(s):  
Yasar Cokkeser ◽  
Mustafa Tercan ◽  
Cem Evereklioglu ◽  
Ibrahim F. Hepsen
Keyword(s):  
Postoperative Complications ◽  
Success Rate ◽  
External Approach ◽  
Prospective Evaluation ◽  
Lacrimal Sac ◽  
Successful Completion ◽  
Patients Âgés ◽  
Minimal Morbidity ◽  
Patient Tolerance

We performed a prospective evaluation of endoscopic hammer-chisel dacryocystorhinostomy (DCR) procedures on 62 eyes of 44 patients (40 female and 4 male) with chronic epiphora or dacryocystitis (26 unilateral and 18 bilateral). The technique included chisel removal of bone over the lacrimal sac. The follow-up period was 12 to 54 months (mean, 28 months), and the patients' ages ranged from 17 to 67 years (mean, 35.5 years). The success rate of the consecutive endoscopic hammer-chisel DCR procedures was 87%. During operation, 8 patients had mild mucosal hemorrhage, which did not prevent the successful completion of the operation. Excellent patient tolerance was observed, with minimal morbidity and no major complications. As compared to the external approach, endoscopic hammer-chisel DCR is less traumatic, is less time-consuming, and is practical and cosmetically convenient, with minimal perioperative and postoperative complications. It also allows the simultaneous correction of any intranasal disease. It requires minimal instrumentation and is a relatively easy and fast technique.

scholarly journals The Fibrin Glue Application Enhances Surgical Success Rate in Endonasal Endoscopic Dacryocystorhinostomy With Lacrimal Sac Preservation

2019 ◽  
pp. 014556131988212 ◽  
Author(s):  
Seyit Mehmet Ceylan ◽  
Ceren Erdoğan ◽  
Tevfik Sozen ◽  
Mahmut Alper Kanmaz ◽  
Ilyas Disikirik ◽  
...  
Keyword(s):  
Success Rate ◽  
Fibrin Glue ◽  
Complication Rate ◽  
Anastomosis Group ◽  
Lacrimal Sac ◽  
Endoscopic Endonasal ◽  
Subjective Report ◽  
Positive Functional ◽  
Surgical Success ◽  
Endoscopic Dacryocystorhinostomy

The purpose of this study to compare lacrimal sac flap preserving techniques with or without fibrin glue in patients undergoing endoscopic endonasal dacryocystorhinostomy. A retrospective study included 132 patients who underwent unilateral endonasal dacryocystorhinostomy between February 2011 and March 2016. Patients were divided into 2 groups: the nonfibrin glue group (n = 66) and fibrin glue anastomosis group (n = 66). Surgical success was defined as the patients’ subjective report of relief of epiphora and objective endoscopic confirmation of ostium patency confirmed by a positive functional dye test. These parameters were compared between the 2 groups. Both groups were similar, in terms of demographic and clinical characteristics. The surgical success rate was significantly higher in the fibrin glue anastomosis group (95.5%) than in the nonfibrin glue group (84.8%; P = .041). Complication rate was 6.1% in the nonfibrin glue group, whereas in the fibrin glue anastomosis group, it was 4.5%. The complication rate was similar in both groups ( P = .99). Creation of an anastomosis between the lacrimal sac flaps and the nasal mucosa using fibrin glue improves the outcome of endonasal endoscopic dacryocystorhinostomy.

scholarly journals Powered endoscopic endonasal dacrocystorhinostomy using inferiorly based mucosal flap: our experience

2019 ◽  
Vol 5 (4) ◽  
pp. 936
Author(s):  
Ramya B. ◽  
Suprabha M. H. ◽  
Prakash M. D.
Keyword(s):  
Simple Procedure ◽  
Nasolacrimal Duct ◽  
Medial Wall ◽  
Critical Element ◽  
Lacrimal Sac ◽  
Term Outcome ◽  
Endoscopic Endonasal ◽  
Long Term Outcome ◽  
Mucosal Flap

<p class="abstract"><strong>Background:</strong> The most critical element for successful management of lacrimal system pathology distal to common canaliculus that requires endoscopic endonasal dacrocystorhinostomy (EEDCR) is the creation of widest possible marsupialisation of the medial wall of the lacrimal sac. With minor modifications and simplication of the original technique of EEDCR, common surgical failures like obstruction of neo-ostium by granulation tissue or infolding of flap can be avoided. To determine the success of EEDCR using inferiorly based mucosal flap, removal of overlying bone using Kerrison’s punch followed by vertical incision of the medial wall of lacrimal sac with microdebrider assisted trimming of the lacrimal sac flaps.</p><p class="abstract"><strong>Methods:</strong> A total of 31 patients with epiphora secondary to nasolacrimal duct obstruction (NLDO) were operated using the above technique with 3 bilateral cases amounting to a total of 34 procedures. The surgical outcome and long term patency of neo-ostium were evaluated.  </p><p class="abstract"><strong>Results:</strong> Of the 34 procedures, 32 procedures (94.1%) had complete resolution of epiphora at the end of one year follow up. The 2 failures were due to canaliculitis.</p><p class="abstract"><strong>Conclusions:</strong> Powered EEDCR with trimming of medial wall of lacrimal sac and inferiorly based mucosal flap preservation to cover the exposed part of bone is a simple procedure with favourable long term outcome.</p>

scholarly journals ENDOSCOPIC ENDONASAL DACRYOCYSTORHINOSTOMY: EXPERIENCE OF HUNDRED CASES

2021 ◽  
Vol 71 (6) ◽  
pp. 2104-08
Author(s):  
Muhammad Shahid ◽  
Muhammad Awais ◽  
Amjad Akram ◽  
Syed Abid Hassan Naqvi ◽  
Omar Zafar ◽  
...  
Keyword(s):  
Armed Forces ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Sample Population ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Lacrimal System ◽  
Chronic Dacryocystitis ◽  
Quasi Experimental ◽  
External Dacryocystorhinostomy

Objective: To determine the success rate of Endonasal Endoscopic Dacryocystorhinostomy (Endo-DCR) in cases of chronic dacryocystitis secondary to primary acquired nasolacrimal duct obstruction (NLDO). Study Design: Quasi-experimental study. Place and Duration of Study: Department of Oculoplastic Surgery, Armed Forces Institute of Ophthalmology Rawalpindi, from Sep 2018 to Nov 2019. Methodology: Endo-DCR under General Anaesthesia was performed on 100 patients of primary acquired nasolacrimal duct obstruction causing chronic dacryocystitis. Post-operatively these patients were checked on first post-op day, then on one week and finally four months after surgery. We removed silicone tubes of all the patients four months after surgery. To ensure patency of lacrimal passage, we did syringing and irrigation of lacrimal system of all cases, at conclusion of the study. We chose absence of epiphora and patent lacrimal system on syringing as indicators of successful procedure. Results: Hundred patients (males 37; females 63) were recruited for this study. Mean age of our sample population was 51.1 ± 29 years. Right nasolacrimal duct obstruction cases were 56 whereas left nasolacrimal duct obstruction cases were 44. Subjective improvement i.e., absence of epiphora was found in 90% patients. We got successful irrigation of lacrimal passages (objective improvement) in 94% of patients. Conclusion: Endo-DCR yields comparable results to external Dacryocystorhinostomy (Ex DCR). It offers additional benefits of esthetically better outcome, lesser complication rate and short surgery and patient recovery time.

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