scholarly journals A comparative study in the use of topical mitomycin-C versus nasolacrimal stent in endoscopic dacryocystorhinostomy for chronic dacryocystitis

2017 ◽  
Vol 4 (1) ◽  
pp. 176 ◽  
Author(s):  
Vikas Gupta ◽  
Inderdeep Singh ◽  
Gunjan Dwivedi ◽  
Sunil Goyal ◽  
Manoj Kumar ◽  
...  
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
P Value ◽  
Lacrimal Sac ◽  
Endoscopic Dacryocystorhinostomy ◽  
Chronic Dacryocystitis ◽  
Significant Difference ◽  
Silicone Stent ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Inflammation of the lacrimal sac and duct is a common and unpleasant condition, leading to troublesome epiphora and recurrent dacryocystitis. Surgery is the preferred treatment modality of chronic dacryocystitis which can be performed by external approach or endoscopic nasal approach. Endoscopic dacrycocystorhinostomy (EnDCR) is now a well-established procedure to relieve nasolacrimal duct obstruction, becoming ENT surgeons’ domain. The aim of this study is to assess the efficacy and compare results of intraoperative use of nasolacrimal stent in comparison of mitomycin-C (MMC) in endoscopic dacryocystorhinostomy.</p><p class="abstract"><strong>Methods:</strong> A prospective study of 56 patients with acquired NLDO with epiphora and recurrent dacryocystitis who were evaluated and managed between Oct 2014 and Oct 2016. All patients were offered surgical line of management by endoscopic route. They were randomly assigned into two groups-mitomycin-C group (Group A) and silastic nasolacrimal stenting (Group B). 46 patients who matched inclusion criteria’s were included in the study after formal evaluation by ENT surgeon and Ophthalmologist. 26 patients underwent endoscopic dacryocystorhinostomy with Mitomycin-C application intra – op, 20 patients underwent nasolacrimal silicone stent placement.  </p><p class="abstract"><strong>Results:</strong> At 6-month follow-up visit, the management was considered successful if the lacrimal sac irrigation succeeded with relief of symptoms. The success rate in Group A was 92.30%. Group B had 85% success rate. However, no significant (p value=0.37) was noticed between two groups.</p><p><strong>Conclusions:</strong> Despite, no significant difference in outcome between two modalities, there is a trend towards the better outcome with use of mitomycin-C. Mitomycin-C is a safe, effective, and economical adjuvant in endoscopic DCR assisting in improved outcomes of surgery. </p>

scholarly journals A Study of Efficacy of Intraoperative Application of Mitomycin-C in Endoscopic Dacryocystorhinostomy

2018 ◽  
Vol 26 (1) ◽  
pp. 29-34
Author(s):  
Harikesh Sharma ◽  
Ajay Mallick
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Symptomatic Improvement ◽  
Age Group ◽  
Female Ratio ◽  
Endoscopic Dacryocystorhinostomy ◽  
Chronic Dacryocystitis ◽  
Group A ◽  
Endoscopic Dcr ◽  
Group B

Introduction Common cause for failure of endonasal dacryocystorhinostomy is closure of the intranasal ostium usually due to granulation tissue formation. Attempts have been made to improve the success rate of lacrimal surgery by using different methods like using balloon catheters, lasers and antimetabolites. This study aims to see change in success rate with and without the use of using Mitomycin-C in endonasal Dacryocystorhinostomy (DCR) surgery. Materials and Methods Sixty patients of acquired chronic dacryocystitis with nasolacrimal duct blockage, in the age group of 11-50 yrs were taken for study. Patients were alternatively divided into two groups A & B (30 patients in each group). Endoscopic dacryocystorhinostomy with Mitomycin-C application was performed in Group A and without Mitomycin-C application in Group B patients. Subjective assessment for symptomatic improvement and objective analysis obtained from results of syringing. The result data was subjected to Student’s t test and x2analysis. Result Age of patients varied from 11 to 50 yrs. The male to female ratio was 7:8 in group A while 2:3 in group B. The commonest age group was between 21 -30 years in both the groups. After 12 month follow up the success rate was 93% in both the groups. The results between the groups were found to be statistically not significant (p>0.05). Conclusion Mitomycin C was used in this study to assess its efficacy in improving the results of endoscopic DCR. Mitomycin C did not have significant effect on the outcomes of endoscopic DCR surgery for chronic dacryocystitis.

scholarly journals Comparison of early versus standard timing for silicone stent removal following External Dacrocystorhinostomy under local anaesthesia

2019 ◽  
Vol 11 (1) ◽  
pp. 24-28
Author(s):  
Ben Limbu ◽  
Hannah S Lyons ◽  
Mohan Krishna Shrestha ◽  
Geoffrey C Tabin ◽  
Rohit Saiju
Keyword(s):  
Success Rate ◽  
Financial Burden ◽  
Controlled Trial ◽  
Nasolacrimal Duct ◽  
Complication Rates ◽  
Tube Removal ◽  
Significant Difference ◽  
Silicone Stent ◽  
Group A ◽  
Group B

Introduction: The first line treatment for nasolacrimal duct obstruction (NLDO) is external dacrocystorhinostomy (DCR). Following DCR, patients are required to return to Tilganga Institute of Ophthalmology (TIO) six weeks postoperatively for the removal of a silicone stent. As the majority of patients travel large distances at significant cost to reach TIO, most often patients remain within Kathmandu during this six weeks interval. This places a large financial burden on patients. Methods: A randomized controlled trial was designed to compare patient outcomes after early (two weeks postoperatively) versus standard (six weeks postoperatively) removal of silicone stents. 50 selected patients were randomized into two equal groups. Results: At the time of publication, 31 patients (14 in group A and 17 in group B) had completed three months follow up. A success rate of 92.9% was noted in Group A and a success rate of 94.1% observed in group B. No significant difference was found between the two groups for success rate and rate of complications. Conclusion: Early tube removal post DCR appears to cause no significant difference in outcome or complication rates compared to standard tube removal.

scholarly journals Evaluation and Comparison of the Outcomes of Endoscopic Dacryocystorhinostomy with and without Silicone Stent

2021 ◽  
Vol 28 (3) ◽  
pp. 221-227
Author(s):  
Bipin Kishore Prasad ◽  
Krishna Kamal Ghosh
Keyword(s):  
Success Rate ◽  
Symptom Relief ◽  
Nasolacrimal Duct ◽  
Complete Relief ◽  
Success Rates ◽  
Endoscopic Dacryocystorhinostomy ◽  
Silicone Stent ◽  
Group A ◽  
Group B ◽  
Sac Syringing

Introduction   Endoscopic dacryocystorhinostomy aims to establish a patent nasolacrimal fistula. Use of silicone stent is a preferred modification to achieve long term patency of neo-ostium, though it has been blamed for granulations, synechia and punctal erosion. Present study was done to  evaluate and compare the outcomes of Endoscopic dacryocystorhinostomy with and without stent.  Materials and Methods 40 patients of with chronic dacryocystitis and nasolacrimal duct blockage were selected for the study. Nasal endoscopy was done for suitability of surgical access and to detect any nasal pathology. Sac syringing was done to assess the site of blockage and Dacryoscintigraphy to confirm it. 20 patients in Group A underwent Endoscopic dacryocystorhinostomy without stent and remaining 20 in Group B with silicone stent. Success rates were determined by subjective relief from epiphora and by endoscopic visualization of rhinostomy opening, granulation tissues/ synechiae at rhinostomy site and by result of sac syringing.  Results In Group A, complete relief was obtained in 75% patients, significant relief in 10% and no relief in 15% patients thus recording overall success rate of 85%; whereas in Group B complete relief of symptom was obtained in 70% patients, significant relief in 10% and no symptom relief in 20% patients thus recording the overall success rate of 80%. Cases in Group B were also found to have persistent epiphora (17.5%), stenosis of ostium (25%), granulation (35%) and synechia (37.5%).  Conclusion Stenting does not significantly improve the success of Endoscopic dacryocystorhinostomy but is associated with more complications.

scholarly journals Efficacy of Ahmed Glaucoma Valve and Trabeculectomy With Mitomycin-C in Pediatric Glaucoma

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manzoor Ahmed Khan ◽  
Sadia Bukhari ◽  
Zafar Ahmed Khan ◽  
Mahtab Mengal ◽  
Muhammad Afzal Khan ◽  
...  
Keyword(s):  
Mitomycin C ◽  
Valve Surgery ◽  
P Value ◽  
Pediatric Ophthalmology ◽  
Ahmed Glaucoma Valve ◽  
Duration Of Symptoms ◽  
Pediatric Glaucoma ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objective: To compare the efficacy between Ahmed glaucoma valve surgery and Trabeculectomy with Mitomycin-c in pediatric glaucoma. Study design and setting: Quasi-experimental study was conducted at Pediatric Ophthalmology Department, ISRA Post graduate Institute of Ophthalmology/ Al-Ibrahim Eye Hospital, Karachi. Duration of study was February to August 2016. Methodology: Samples were divided into two groups. Group A Trabeculectomy with Mitomycin-C and Group B with Ahmed Glaucoma valve surgery. Inclusion criteria were children (above 2 years and less than 15 years of age) visiting Pediatric Ophthalmology OPD irrespective of gender, glaucoma diagnosed with the duration of symptoms > 4 weeks. Exclusion criteria were patient with repeat surgery for glaucoma, combined ocular surgery i.e penetrating keratoplasty or cataract, Preoperative keratitis, uveitis or conjunctivitis, as determined by slit-lamp examination. Paired sample t-test was applied to compare the pre and post IOP examination findings. P-value = 0.05 considered as statistically significant. Results: A total of 110 patients were recruited in this study in which 97 patients were analyzed. Mean age of Group A was 6.73±2.7 and mean age of Group B was 7.05±2.3. Mean pre-operative IOP in “Group A” was found to be 31.59±5.4 and post-operative IOP was reduced to 17.95±4.8 with statistically significant P-value <0.0001. In “Group B” Mean preoperative IOP was 30.60±5.3 and post-operative IOP was 18.43±3.8 with statistically significant P-value <0.0001. Conclusion: A significant difference found between efficacy of Ahmed glaucoma valve surgery and Trabeculectomy with Mitomycin-C in pediatric glaucoma after 4th week of surgery.

scholarly journals A Comparative Study of Dacryocystorhinostomy with or without Stent in a Tertiary Teaching Hospital of Telangana

2021 ◽  
Vol 8 (20) ◽  
pp. 1532-1537
Author(s):  
Imtiaz Ahmed Khan ◽  
Naseeruddin Mujahid ◽  
Nabeel Nabeel
Keyword(s):  
Success Rate ◽  
Symptomatic Relief ◽  
Nasolacrimal Duct ◽  
Chronic Dacryocystitis ◽  
Duct Occlusion ◽  
Tertiary Teaching ◽  
Significant Difference ◽  
Group A ◽  
Endonasal Dcr ◽  
Group B

BACKGROUND Epiphora is a common annoying symptom, embarrassing the patient both socially and functionally and may even endanger the eye. Chronic Dacryocystitis is the most common cause of epiphora which arises from nasolacrimal duct occlusion. Dacryocystorhinostomy (DCR) is the procedure of choice in the management of Dacryocystitis. We wanted to study the final outcome following endonasal DCR for chronic dacryocystitis with or without using silicon stent, evaluate the causes of persistence of epiphora in patients with or without the use of lacrimal stents and identify the methods of overcoming them postoperatively. METHODS A case control study to compare the results of Endonasal DCR with and without stent was conducted among 96 patients of both genders aged above 20 years with symptoms and signs suggestive of nasolacrimal duct blockage. All the cases and controls were randomly selected and included as group A and group B. RESULTS 96 patients were included in this study and they were divided into two groups (Group A and Group B) with 48 patients in each group. More than 75 % of the patients were between 31 and 60 years of age with a mean age of 44.36 ± 3.15 years. In Group B, 72.91 % of the cases were between 31 and 60 years of age with a mean age of 45.50 ± 4.10 years. There was no statistically significant difference in both groups. In group A (DCR with stent) success rate or relief of symptoms was 96 % whereas in group B (DCR without stent) success rate or symptomatic relief was 80 %. CONCLUSIONS Endoscopic endonasal DCR with stent is a safe and minimally invasive procedure and is an effective treatment for patients who have failed primary endoscopic DCR without stent and also in cases of mucocele and pyocele of the sac. KEYWORDS Chronic Dacryocystitis, Dacryocysto-Rhinostomy, Nasolacrimal Duct and Endoscopic Dacryocysto-Rhinostomy

scholarly journals Assessment of the outcome of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of chronic otitis media

2020 ◽  
Vol 6 (11) ◽  
pp. 2001
Author(s):  
Sreeshma Balan ◽  
Prakash M. D.
Keyword(s):  
Success Rate ◽  
Otitis Media ◽  
Statistical Significance ◽  
Chronic Otitis Media ◽  
P Value ◽  
Hearing Improvement ◽  
Cortical Mastoidectomy ◽  
Significant Difference ◽  
Group A ◽  
Group B

<p class="abstract"><strong>Background:</strong> Chronic otitis media (COM) is an inflammatory process in the middle ear space that results in long-term changes in the tympanic membrane including atelectasis, dimeric-membrane formation, perforation, tympanosclerosis, retraction pocket or cholesteatoma. COM can be classified into healed, inactive (mucosal or squamosal), active (mucosal or squamosal). Myringoplasty is tympanoplasty without ossicular reconstruction. Cortical mastoidectomy is usually accompanied by tympanoplasty. Aim was to assess and compare the efficacy of myringoplasty with cortical mastoidectomy in dry and wet mucosal type of COM, in terms of graft uptake and hearing improvement.</p><p class="abstract"><strong>Methods:</strong> A prospective study, where 30 patients each of wet and dry mucosal-type COM were included. Patients underwent myringoplasty with cortical mastoidectomy. All were followed up for 6 months, both the groups were statistically compared.  </p><p class="abstract"><strong>Results:</strong> In our study, mean age of patients in group A (wet COM) was 34.13 years and group B (dry COM) was 33.36 years. Group A had success rate of 90% and group B had success rate of 86.6%. There was no statistical significance (p value- 0.53) on comparing both groups with respect to graft uptake. There was significant hearing improvement post-operatively in both the groups (p&lt;0.05). However, there was no significant difference between the groups (p value- 0.66). This shows that presence of discharge at the time of surgery does not interfere with the results of cortical mastoidectomy with myringoplasty.</p><p class="abstract"><strong>Conclusions:</strong> We conclude that, there is good outcome in both wet and dry COM following myringoplasty with cortical mastoidectomy with respect to graft uptake and hearing improvement.</p>

scholarly journals Comparative study of endonasal dacryocystorhinostomy with and without adjunctive topical use of Mitomycin C

2017 ◽  
Vol 5 (7) ◽  
pp. 3208 ◽  
Author(s):  
Ganesh P. Kulkarni ◽  
Ashwini S. Handal
Keyword(s):  
Mitomycin C ◽  
Tertiary Care ◽  
Scar Tissue ◽  
Lateral Nasal Wall ◽  
Tertiary Care Centre ◽  
Endoscopic Dacryocystorhinostomy ◽  
Mucosal Tissues ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Endoscopic dacryocystorhinostomy has now established itself in the treatment of lacrimal obstruction. Failures in endoscopic dacryocystorhinostomy are mainly due to reclosure of the stoma in the lateral nasal wall. Mitomycin-C is an alkylating agent used in the chemotherapy of various cancers. Mitomycin-C when topically applied to mucosal tissues has been reported to inhibit excessive scar tissue and granulation tissue formation, resulting in greater success rates.Methods: To evaluate the efficacy of Mitomycin-C in preventing reclosure of the dacryocystorhinostomy stoma, we performed a prospective, randomized case control study between November 2013 and October 2015. The study was conducted at tertiary care centre. The study sample consisted of 50 patients, who were randomly assigned to two groups, Group A which received the application of Mitomycin-C topically to the dacryocystorhinostomy stomal site and Group B which did not receive this intervention. The patients were regularly followed up for 6 months.Results: 24 patients (96%) out of 25 in the Group A, had a successful surgical outcome. In Group B 23 patients (92%) out of 25 were symptom free after surgery. These results indicated no statistically significant difference between the two groups (p>0.05). Hence the results of this study did not show any significant benefit for the use of Mitomycin-C as an adjunct during primary endoscopic dacryocystorhinostomy.Conclusions: An atraumatic and meticulous surgical technique along with a good follow up care post-operatively establishes endoscopic dacryocystorhinostomy as an effective treatment modality for chronic dacryocystitis.

scholarly journals Comparison between scalpel incision and electrocautery incision in midline abdominal surgery: a comparative study

2021 ◽  
Vol 8 (5) ◽  
pp. 1507
Author(s):  
Amit Yadav ◽  
Lakshman Agarwal ◽  
Sumit A. Jain ◽  
Sanjay Kumawat ◽  
Sandeep Sharma
Keyword(s):  
Postoperative Pain ◽  
Blood Loss ◽  
Abdominal Surgery ◽  
Wound Infection ◽  
Skin Incision ◽  
P Value ◽  
Wound Area ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Fear of poor wound healing have curtailed the use of diathermy for making skin incision. Scalpel produces little damage to surrounding tissue but causing more blood loss. Our aim of study was to compare electrocautery incision with scalpel incision in terms of incision time, blood loss, postoperative pain and wound infection.Methods: Total of 104 patients were included in the study undergoing midline abdominal surgery. Patients were randomized into electrocautery (group A) and scalpel (group B). The incision dimension, incision time and blood loss were noted intraoperatively. Postoperative pain was noted on postoperative day 2 using visual analog scale. Wound complications were recorded on every postoperative day till the patient was discharged.Results: 52 patients in each of the two groups were analyzed. There was significant difference found between group A and group B in terms of mean incision time per unit wound area, 8.16±1.59 s\cm2 and 11.02±1.72 s\cm2 respectively (p value=0.0001). The mean blood loss per unit wound area was found to be significantly lower in group A (0.31±0.04 ml\cm2) as compared to group B (1.21±0.21), p value=0.0001. There was no significant difference noted in terms of postoperative pain and wound infection between both groups.Conclusions: Electrocautery can be considered safe in making skin incision in midline laparotomy compared to scalpel incision with comparable postoperative pain and wound infection with less intraoperative blood loss and less time consuming.

scholarly journals Comparison of Recovery Time of Propofol and Midazolam with Propofol Alone for Sedation in Endoscopic Retrograde Cholangiopancreatography

2021 ◽  
Vol 15 (5) ◽  
pp. 1024-1027
Author(s):  
Asma Samreen ◽  
Aamir Waseem ◽  
Muhammad Azam ◽  
Itrat Hussain Kazmi ◽  
Aamir Bashir ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Recovery Time ◽  
Controlled Trial ◽  
P Value ◽  
Time Data ◽  
Endoscopic Retrograde ◽  
Intravenous Anesthetic ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Procedural sedation is required for multiple short duration procedures outside of the operating rooms especially in radiology and endoscopy suites. Intravenous anesthetic agent with rapid recovery profile is desirable in such circumstances. This study aims to compare two regimens of intravenous anesthetic agents. Aim: To compare the mean recovery time of propofol and midazolam with propofol alone for sedation in endoscopic retrograde cholangiopancreatography. Study Design: Randomized controlled trial. Settings: Department of Anesthesia, Shalamar Hospital, Lahore. Study Duration: June 2017 to December 2017. Methods: A total of 70 adult patients aged 20-60 years undergoing ERCP under sedation were included. Patients were given a combination of propofol and midazolam in group A while propofol alone was given in group B. After procedure, pts were transferred to recovery room and were followed for assessment of recovery time. Data were analyzed in SPSS vr 21, Independent t-test was applied & p-value ≤0.05 was considered statistically significant. Results: Significant difference was found in mean recovery time amongst both the groups. Mean recovery time in Group A (propofol and midazolam) was 19.29±4.50 minutes while in Group B (propofol alone) was 26.66±3.70 minutes showing statistically significant result with p-value = 0.0001. Conclusion: We conclude that mean recovery time with propofol plus midazolam is shorter as compared to propofol alone for sedation in ERCP. Keywords: Propofol, midazolam, sedation outside operation theatre.

Combination Therapy Of Tadalafil And Pentoxifylline In Severe Erectile Dysfunction; A Prospective Randomized Trial

2015 ◽  
Vol 87 (8) ◽  
Author(s):  
Santosh Kumar ◽  
Rajesh Roat ◽  
Swati Agrawal ◽  
Kumar Jayant ◽  
Ravimohan S. Mavuduru ◽  
...  
Keyword(s):  
Erectile Dysfunction ◽  
Combination Therapy ◽  
Erectile Function ◽  
T Test ◽  
P Value ◽  
Chi Square ◽  
Significant Difference ◽  
Chi Square Test ◽  
Group A ◽  
Group B

Abstractwas to assess efficacy of Tadalafil alone versus Tadalafil plus Pentoxifylline in the treatment of erectile dysfunction by using self administered IIEF-5 questionnaire.Two hundred and thirty seven patients presenting with ED at andrology OPD were evaluated for ED by a self administered IIEF (International Index of Erectile Function) questionnaire. Patients were systematically randomized by computer generated random table into two groups groups namely, group A: Tadalafil only group, group B: combination of Tadalafil + Pentoxifyl-line. All the patients were re-assessed by IIEF-5 questionnaire after 8 weeks of medical therapy. Statistical analysis was performed using student’s unpaired t-test, paired t-test, chi square test. p-value < 0.05 was considered statistically significant.Two hundred and thirty seven patients were included in the present study, in group A: 92 patients (78.6%) showed improvement in their IIEF score after 8 weeks of tadalafil treatment. While in group B, overall 104 patients(86.6%) showed improvement after combination of Tadalafil and Pentoxifylline. There was a statistically significant difference of percentage change in IIEF score was seen in group B (group A 90.7±15.2%, group B 95.6±13.4%; p value – 0.014). We found this difference even more statistically significant in patients with severe ED (group A 72.7±47.2%, group B 132.3±54.3%; p value – 0.000). There was no significant difference in between the two groups with regards to occur-rence of side effects.Both tadalafil and combination of Tadalafil + Pentoxifylline improve erectile function in patients of ED. Patients with severe ED showed much significant improvement in erectile function with combination therapy.

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