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 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 A Comparative Study of Endoscopic Endonasal Dacryocystorhinostomy with and without Intraoperative Mitomycin-C Application

2013 ◽  
Vol 6 (1) ◽  
pp. 5-9 ◽  
Author(s):  
Raman Wadhera ◽  
Sat Paul Gulati ◽  
Ashok Kumar Khurana ◽  
Harikesh Sharma ◽  
Vijay Kalra ◽  
...  
Keyword(s):  
Comparative Study ◽  
Success Rate ◽  
Mitomycin C ◽  
Nasolacrimal Duct ◽  
Complete Relief ◽  
Tertiary Referral Hospital ◽  
Endoscopic Endonasal ◽  
Group A ◽  
Endonasal Dcr ◽  
Group B

ABSTRACT Aim To evaluate the role of intraoperative mitomycin-C application in primary endoscopic endonasal dacryocystorhinostomy (DCR) and compare the results with conventional endoscopic endonasal DCR. Study design Prospective comparative interventional study. Setting Tertiary referral hospital. Materials and methods Fifty patients in the age group of 16 to 50 years presenting with symptoms and signs suggestive of nasolacrimal duct blockage refractory to conventional medical treatment were included in the study. They were assigned randomly into two groups of 25 patients each. Group A patients underwent endoscopic endonasal DCR followed by application of mitomycin-C. Group B patients underwent endoscopic endonasal DCR without application of mitomycin-C. The two groups were compared with regard to success rate and complications. The main outcome measures for success were the resolution of epiphora and patency with lacrimal irrigation. Results After 1 year, 24 patients (96%) in each group had complete relief from their symptoms while one patient (4%) had no relief. Syringing was patent in 24 patients (96%) in each group and blocked in one patient (4%) after 1 year of surgery. Conclusion The present study did not show any additional benefit of using mitomycin-C at the stoma site after primary endoscopic endonasal DCR in terms of success rate. How to cite this article Wadhera R, Gulati SP, Khurana AK, Sharma H, Kalra V, Ghai A. A Comparative Study of Endoscopic Endonasal Dacryocystorhinostomy with and without Intraoperative Mitomycin-C Application. Clin Rhinol An Int J 2013;6(1):5-9.

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>

Calcium dobesilate and oxerutin: effectiveness of combination therapy

2010 ◽  
Vol 25 (2) ◽  
pp. 66-71 ◽  
Author(s):  
B Akbulut
Keyword(s):  
Combination Therapy ◽  
Venous Insufficiency ◽  
Statistical Significance ◽  
Symptomatic Relief ◽  
Antioxidant Properties ◽  
Erythrocyte Aggregation ◽  
Calcium Dobesilate ◽  
Significant Difference ◽  
Group A ◽  
Group B

Objectives Chronic venous insufficiency (CVI) is an important cause of discomfort and inability to work. Hydroxyethylrutosides (Venoruton®; 0-[beta-hydroxyethyl]-rutosides) has been used for decades for the treatment of CVI. Studies have reported symptomatic relief and a decreased capillary filtration after the administration of the oral preparations. Calcium dobesilate is a synthetic venoactive drug acting on several levels. It inhibits capillary permeability; it has antioxidant properties; and it inhibits the synthesis of prostaglandins and thromboxanes, reducing platelet and erythrocyte aggregation, as well as blood viscosity. The aim of this study is to determine whether the combination of both drugs is more effective in decreasing patients' complaints. Methods One hundred and fifty patients with primary venous insufficiency were randomized into three groups: Group A receiving calcium dobesilate only, Group B receiving oxerutin only and Group C receiving both calcium dobesilate and oxerutin. Patients were evaluated with a questionnaire before and four weeks after treatment regarding following parameters: itching, fatigue, heaviness, numbness, cramp, swelling and sensitiveness. Patients rated their symptoms from 0 to 4 (0: absent; 1: mild; 2: moderate; 3: severe; 4: very severe). Results Complaints, which were scored by patients before and after treatment, decreased. Among the single-drug groups, itching score decreased more in Group B, whereas scores of fatigue, heaviness, numbness, cramp and swelling decreased more in Group A. But the difference was not significant, statistically. But all complaints decreased significantly in Group C. Difference of scores after treatment revealed no statistical significance in Group A and B, but scores of Group C produced a significant difference when compared with Group A and B. Conclusion Results demonstrate that a combination of calcium dobesilate and oxerutin shows a better improvement of complaints. These observations have to be confirmed in larger series with objective tests. Changes of quality of life after a combination therapy might also be of interest.

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.

Endoscopic endonasal dacryocystorhinostomy vs nasolacrimal duct intubation in pediatric nasolacrimal duct obstruction - a comparative study

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Rana Atia ◽  
Magda Samy ◽  
Sheriff Elwan ◽  
Thanaa Helmy ◽  
Ashraf Shaat ◽  
...  
Keyword(s):  
Postoperative Complications ◽  
Success Rate ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Tube Removal ◽  
Group A ◽  
The Difference ◽  
Group B

Abstract Study design; Pilot randomized controlled study. Objective To compare success rates of endoscopic endonasal dacryocystorhinostomy and nasolacrimal duct intubation in congenital nasolacrimal duct obstruction (NLDO) in a trial to define the superiority of either technique. Patients & Methods Sixty-six eyes of 61 patients were diagnosed as having epiphora and mucopurulent discharge due to congenital NLDO. The patients were randomly divided into two groups; Group A; 33 eyes of 28 patients (treated by probing and silicone intubation only (NLDI)) and Group B; 33 eyes of 33 patients (treated by endoscopic endonasal dacryocystorhinostomy and silicone tube intubation (EDCR). All tubes were removed 6 months after the operation. Results The success rate, defined as complete resolution of clinical symptoms and signs after 6 months of follow up, was 72.7 % in Group A and 81.8% in Group B. Although the success rate was higher in Group B, yet the difference was shown to be statistically nonsignificant. Preoperative symptoms were assessed postoperatively after tube removal. Complete cure had a higher rate of occurrence in Group B than in Group A (27eyes (81.8%) versus 25 eyes of 22 patients (75.8%) respectively). Postoperative positive fluorescein dye disappearance test (FDDT) after tube removal was more in Group B than in Group A (27 eyes (81.8) versus 24 eyes of 21 patients (72.7 %) respectively). In Group A, silicone tubes had to be repositioned due to prolapse in 3 eyes of 3 patients (9.1%) and had to be removed early in 3 eyes of 3 patients (9.1%) due to failure of repositioning. In Group B, silicone tubes did not require early tube extraction before the date of removal in any of the patients. Intraoperative, there was only one case (3.0%) of fat prolapse during EDCR in Group B with no subsequent postoperative complications. Hemostasis did not represent a problem in any of the patients. Postoperative complications occurred more in Group B than Group A (21 eyes (63.6%) versus 13 eyes of 13 patients (39.4 %) respectively). Late complications occurred more in Group B than Group A (18 eyes (54.5%) versus 12 eyes of 12 patients (36.4%) respectively) in the form of persistent epiphora and tube prolapse. Conclusion The success rate of pediatric EDCR was higher than that of pediatric NLDI. The difference was statistically non-significant. Complications were comparable between the two groups. The study, being pilot in its comparative aspect between endoscopy and intubation, opens the horizon for further study on a larger group that probably will expand this difference.

scholarly journals Comparison of marsupialization under nasal endoscopy versus lacrimal probing for treatment of congenital dacryocystoceles: a report of 40 cases

2020 ◽  
Author(s):  
Yan-Hui Cui ◽  
Peng Sun ◽  
Li-Xing Tang ◽  
Cheng-Yue Zhang ◽  
Qian Wu ◽  
...  
Keyword(s):  
Success Rate ◽  
Reoperation Rate ◽  
Nasal Endoscopy ◽  
Controlled Study ◽  
Lacrimal Duct ◽  
Nasal Endoscope ◽  
Randomized Controlled ◽  
Significant Difference ◽  
Group A ◽  
Group B

Abstract Background: This study was performed to compare the efficacy of marsupialization under nasal endoscopy versus lacrimal probing for the treatment of congenital dacryocystocele. Methods: A prospective randomized controlled study. Forty neonates (43 eyes) diagnosed with congenital dacryocystoceles were divided into Group A (nasal endoscopic marsupialization) and Group B (lacrimal probing). The patients were followed up for 1 year after surgery. The efficacy, incidence of complications, and reoperation rate were compared between the two groups. Results: The male:female ratio was 25:15 patients (27:16 eyes). In Group A, the success rate was 100%, the incidence of complications was 5%, and the reoperation rate was 0%. In Group B, the success rate was 90%, the incidence of complications was 20%, and the reoperation rate was 30%. There was no significant difference in the success rate between the two groups, but the incidence of complications and the reoperation rate in the lacrimal probing group(Group B) were significantly higher than those in the nasal endoscopic marsupialization group(Group A). Conclusion: In the treatment of congenital dacryocystoceles, nasal endoscope marsupialization has the same success rate as lacrimal duct probing, but the former is more effective and safer in clinical practice.

scholarly journals DACRYOCYSTORHINOSTOMY

2008 ◽  
Vol 15 (01) ◽  
pp. 81-86
Author(s):  
MUHAMMAD NAWAZ ◽  
MUHAMMAD SULTAN ◽  
QAISAR HANIF ◽  
Muhammad Sadiq
Keyword(s):  
Symptomatic Relief ◽  
Cost Effective ◽  
Medical College ◽  
Chronic Dacryocystitis ◽  
Department Of Ophthalmology ◽  
Silicon Tube ◽  
Group A ◽  
Group B ◽  
Study Setting

Purpose: To compare the results of standard dacryocystorhinostomy with the results ofdacryocystorhinostomy done with silicon tube stentting of the lacrimal canaliculi. Study design: This is a hospitalbased, prospective, comparative and interventional study. Setting: Department of Ophthalmology, Allied HospitalPunjab Medical College Faisalabad. Period: January 2006 to December 2006. Methods: Twenty seven patients ofchronic dacryocystitis fulfilling the inclusion criteria were selected and divided in two groups. Group A consisted of 15patients who underwent standard dacryocystorhinostomy and Group B consisted of 12 patients who underwentdacryocystorhinostomy along with intubation of the lacrimal canaliculi with silastic tubes. All the patients were followedup for at least six months post-operatively. Success of the procedure, defined as the symptomatic relief of epiphoraand infection was assessed at the end of follow-up period. Results: Of the total 27 patients of chronic dacryocystitis23 (85%) were female and 4(15%) were male. The mean age of the patients was 45 years. The success of theprocedure was recorded in 14 (93.33%) patients in group-A and in 10 (83.33%) patients in group B. Quite a few andsimple complications were recorded during the study period. Conclusions: 1. Standard externaldacryocystorhinostomy is a simple and cost effective procedure forthe management of chronic dacryocystitis. 2. Silicontube stentting of the lacrimal canaliculi does not have any extra advantage in the management of chronic dacryocystitiswithout canalicular obstruction.

scholarly journals Conventional Dacryocystorhinostomy Versus Pawar’s Implant Dacryocystorhinostomy- A Prospective Study

2019 ◽  
Vol 4 (01) ◽  
Author(s):  
Shivcharan Lal Chandravanshi ◽  
Sunil Kumar Shrivastava ◽  
Devendra Kkumar Shakya ◽  
Uma Saran Tiwari
Keyword(s):  
Success Rate ◽  
Nasal Mucosa ◽  
Clinical Success ◽  
Operating Time ◽  
Nasolacrimal Duct ◽  
Operative Complication ◽  
Chronic Dacryocystitis ◽  
Group B ◽  
Surgical Duration

Purpose: To compare conventional dacryocystorhinostomy (DCR) with Pawar’s intracystic implant dacryocystorhinostomy in terms of surgical technique, complications and success rate for primary acquired nasolacrimal duct obstruction (NLDO). Materials and Methods: This is a prospective comparative, nonrandomized, clinical study. It is carried out on 50 cases of primary acquired NLDO. The 50 cases were divide into two groups; Group A consisting of 30 cases that underwent Pawar’s intracystic implant DCR whereas Group B consisting of 20 cases those operated by conventional DCR technique. Data regarding demographic profile of patients, mode of presentation, diagnosis, intraoperative variables such as surgical duration, intra- and post-operative complications, hospital stay and causes of failure and final surgical outcome, were analyzed. Clinical success was defined as patent lacrimal system on irrigation (objective) and absence of symptoms (subjective). Results: Out of 50 cases 40 (80%) were female and 10 cases (20%) were males. In this study, 39 (78%) cases had chronic dacryocystitis, followed by pyocele/mucocele 5 (10%), chronic dacryocystitis with lacrimal fistula 3 (6%), and previous failed DCR surgery 3 (6%). Hemorrhage from nasal mucosa was observed in 9 cases (45%) during conventional DCR surgery and one case (3.33%) in implant DCR. Hemorrhage from angular vein occurred in 1 case (5%) during conventional DCR. Nasal mucosa was disrupted/damage in 8 cases (40%) during conventional DCR. The average operating time in convention DCR is 110.50 minutes while for Pwar’s implant DCR is 27.33 minutes. The commonest post-operative complication of Pawar’s intracystic implant DCR was obstruction of passage found in 4 cases (13.33%). Hypertrophic scar was the most common postoperative complication in 8 cases (40%) in conventional DCR. Success rate of implant DCR at 2 months follow up was 83.33% and at the end of 3 months after management of failed cases of implant DCR was 96.66%. Success rate of conventional DCR at 2 months follow up was 80% and at the end of 3 months after management of failed cases of conventional DCR was 85%. Conclusion: The success rate of Pawar’s intracystic implant DCR is comparable with conventional DCR with additional advantages such as easy, quick, minimal intra- and post operative complication and possibility of conventional DCR in future in failed Pawar’s implant DCR.

scholarly journals Effect of addition of platelet-rich fibrin to tragal perichondrium graft in the endoscopic trans-canal myringoplasty

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Mohamed Kamel el Awady ◽  
Mohammed E. L. Sharkawy ◽  
Nagah Mohamed abo Mohamed
Keyword(s):  
Success Rate ◽  
Control Group ◽  
Case Group ◽  
Platelet Rich Fibrin ◽  
Hearing Gain ◽  
Matrix Deposition ◽  
Significant Difference ◽  
Repair Mechanisms ◽  
Group A ◽  
Group B

Abstract Background Myringoplasty operation is the reconstruction of the tympanic membrane (TM) which is performed to prevent recurrent discharge of the ear and to improve the hearing impairment which is caused by TM perforation. Platelets are the key factors in tissue repair mechanisms. They provide essential growth factors, which stimulate fibroblasts to create extracellular matrix deposition and neovascularization. The aim of this study is the assessment of the topical use of autologous platelet-rich fibrin (PRF) in the improvement of myringoplasty success rate. Results Patients were divided to two groups, group A included 20 patients who were submitted to myringoplasty operation with adding of PRF from the same patient, and group B included 20 patients who were submitted to myringoplasty operation without adding of PRF. At 6 months postoperatively, the success rate (graft taking) in case group A (95%) was significantly higher than in the control group (70%) (P value = 0.037). Success in terms of hearing gain of the air-bone gap was more than 10 dB achieved in 19 patients (95%) in case group A, and 14 patients (70%) in control group B were with a statistically non-significant difference (P value = 0.079). There was no effect of PRF use on hearing gain in graft-taken cases because hearing gain is related to the closure of TM. Conclusion Topical PRF application over tragal perichondreal graft during myringoplasty is successful, safe, and highly efficient with no complications. PRF improves healing of chronic TM perforations and prevents postoperative infection.

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