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

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.

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

Journal of Evidence Based Medicine and Healthcare ◽

10.18410/jebmh/2021/290 ◽

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

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Silicone Intubation as an Alternative to Dacryocystorhinostomy for Nasolacrimal Drainage Obstruction in Adults

European Journal of Ophthalmology ◽

10.1177/112067219300300204 ◽

1993 ◽

Vol 3 (2) ◽

pp. 71-76 ◽

Cited By ~ 19

Author(s):

K. Psilas ◽

V. Eftaxias ◽

J. Kastanioudakis ◽

C. Kalogeropoulos

Keyword(s):

Success Rate ◽

Drainage System ◽

Nasolacrimal Duct ◽

Silicone Tube ◽

Duct Obstruction ◽

Silicone Tubing ◽

Chronic Dacryocystitis ◽

Silicone Intubation ◽

Lacrimal Drainage

Silicone tubing was used to repair the patency of the nasolacrimal drainage system in 115 patients (four bilaterally) with chronic nasolacrimal duct obstruction. The patients were over 20 years old and 16 were men and 99 women; 46% presented an uncomplicated obstruction with epiphora and 54% presented additional signs of chronic dacryocystitis. We used the technique of Quickert and Dryden with modifications. The silicone tube remained for a mean of 5.5 months (± 2.5 SD). After removal of the tube the follow-up ranged from 6 to 42 months (mean ± SD: 16 ± 9). Patency was maintained in 89% of cases with uncomplicated obstruction and in 69% of those with chronic dacryocystitis (total success rate 78%). We can therefore recommend silicone intubation of the lacrimal drainage system as an alternative to dacryocystorhinostomy (DCR), in adults with obstruction of the nasolacrimal duct. In addition, unlike DCR this technique is bloodless and the operation takes less time.

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Comparative Evaluation of the Success Rate of Pulpotomy in Primary Molars Using Ferric Sulphate (FS) and Mineral Trioxide Aggregate (MTA): A Clinical and Radiographic Study

Journal of Pharmaceutical Research International ◽

10.9734/jpri/2021/v33i59b34390 ◽

2021 ◽

pp. 356-363

Author(s):

Yogesh Somwanshi ◽

Pankaj Chavhan ◽

Arun Sajjanar ◽

Snehal Ughade ◽

Nutan Gutte ◽

...

Keyword(s):

Success Rate ◽

Clinical Success ◽

Mineral Trioxide Aggregate ◽

Clinical Success Rate ◽

Primary Molars ◽

Ferric Sulphate ◽

Primary Molar ◽

Group A ◽

Group B

Purpose: The aim of this present study was to observe clinical, radiographic response of pulp to Ferric Sulphate and Mineral Trioxide Aggregate when used as pulpotomy agent in primary molars. Materials and Methods: Sixty restorable primary molars were selected for the study. The children were chosen who require minimum two pulpotomies in either arch preferably each on the opposite side (i.e. right and left). Primary molars on the right side of the patient were assigned to Ferric Sulphate (FS) (Group A) and left side was assigned for the Mineral Trioxide Aggregate (MTA) (Group B). Statistical analysis was done for pain, swelling, sinus, and fistula and for internal resorption, furcation radiolucency and periapical pathology using the chi-square test. Results: outcome of the present study was observed at 3 month interval and after 6 months. The clinical success rate for MTA (AQUA) and ferric sulphate during 3 and 6 month follow up was 100%. The radiographic follow up of MTA was 100% during 3 and 6 month, whereas it was 96.6% for 3 and 6 month follow up with respect to ferric sulphate. There were no significant differences in the clinical (p>0.1) and radiographic (p>0.98) success rates among both the groups. Conclusion: ferric sulphate was found to be equally effective when compared with MTA. Radiographic success rate was lower for Ferric sulphate (Group A) than that of MTA (Group B) with occurrence of one internal resorption seen with first primary molar.

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Success Rate of Probing for Congenital Nasolacrimal Duct Obstruction in Children

Folia Medica ◽

10.2478/folmed-2018-0054 ◽

2019 ◽

Vol 61 (1) ◽

pp. 97-103 ◽

Cited By ~ 3

Author(s):

Krasina P. Valcheva ◽

Snezhana V. Murgova ◽

Emilia K. Krivoshiiska

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Cure Rate ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

History Of ◽

Group A ◽

Group B

Abstract Aim: To determine the success rate of initial and repeated probing for congenital nasolacrimal duct obstruction (CNLDO) in children between 2-41 months. Patients and methods: One hundred and twelve children aged 1.8 to 13 years responded to the control examination. They were diagnosed with CNLDO in the past and now included in a retrospective study. The mean follow-up period was 5.2 years (from 0.6 to 11.6 years). Patients were divided into two groups according to their age at the time of surgery: group A (2-12 months) and group B (13-41 months). Probing and irrigation of NLD was performed in the Eye Clinic in Pleven under general anesthesia in all subjects. A controlled examination was done to evaluate the effect of probing on the basis of a history of watery eyes, regurgitation test, and dye disappearance test (DTT). Results: Of the 131 eyes in 112 children, 110 eyes (84%) had one probing and 21 eyes (16%) had repeat probing. Success rate of the initial probing was 90% (99 of 110) for all patients’ eyes: 89% (70 of 79) in group A and 94% (29 of 31) in group B. The cure rate of the repeat probing was 76% (16 of 21) for all patients: 88% (7 of 8) in group A and 69% (9 of 13) in group B. The overall success rate of probing was 88% (115 of 131). Conclusion: Nasolacrimal duct probing followed by irrigation is a commonly performed, highly successful treatment for congenital nasolacrimal duct obstruction in children. The success rate for initial and repeated nasolacrimal duct probing is not affected by age.

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Ferric sulfate as pulpotomy agent in primary teeth: twenty month clinical follow-up

Journal of Clinical Pediatric Dentistry ◽

10.17796/jcpd.24.4.d7u6405nw1132705 ◽

2000 ◽

Vol 24 (4) ◽

pp. 269-272 ◽

Cited By ~ 28

Author(s):

Hamijeta Ibricevic ◽

Qumasha Al-Jame

Keyword(s):

Success Rate ◽

Primary Teeth ◽

Root Resorption ◽

Clinical Success ◽

Clinical Success Rate ◽

Ferric Sulfate ◽

Primary Molar ◽

Molar Teeth ◽

The Moment

Seventy primary molar teeth, carious exposed, symptom free, without any sign of root resorption in children aged from 3 to 6 years (main age 4.3yr) were treated with conventional pulpotomy procedures. Ferric sulfate 15.5% solution (applied for 15 second for 35 teeth) and formocresol solution (five minute procedure of Buckley's formula for next 35 teeth) have been used as pulpotomy agents. In both groups, pulp stumps were covered with zinc-oxide eugenol paste. Permanent restorations were stainless steel crowns. Clinical check up was every three-months and radiographic follow-up time was six and twenty months after treatment. Our results within this period revealed 100% clinical success rate in both groups. Radiographic success rate was in both groups 97.2%, while in 2.8% cases has shown internal root resorption. On the basis of these results, we can recommend ferric sulfate as a pulpotomy agent in primary teeth in substitution for formocresol at the moment.

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Long-Term Management of Recurrent Cholecystitis after Initial Conservative Treatment: Endoscopic Transpapillary Gallbladder Stenting

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2018/3983707 ◽

2018 ◽

Vol 2018 ◽

pp. 1-7

Author(s):

Hideki Kamada ◽

Hideki Kobara ◽

Naohito Uchida ◽

Kiyohito Kato ◽

Takayuki Fujimori ◽

...

Keyword(s):

High Risk ◽

Acute Cholecystitis ◽

Success Rate ◽

Clinical Success ◽

Clinical Success Rate ◽

Technical Success ◽

Technical Success Rate ◽

High Risk Patients ◽

Risk Patients

Background. Endoscopic transpapillary gallbladder stenting (ETGBS) is an effective procedure for treating high-risk patients with acute cholecystitis and severe comorbidities. However, the efficacy of ETGBS for recurrent cholecystitis (RC) remains unclear. This study aimed to explore its efficacy in patients with RC for whom cholecystectomy is contraindicated because of its high surgical risk.Methods. Data on 19 high-risk patients who had undergone ETGBS for RC after initial conservative therapy in our institution between June 2006 and May 2012 were retrospectively examined. The primary outcome was the clinical success rate, which was defined as no recurrences of acute cholecystitis after ETGBS until death or the end of the follow-up period. Secondary outcomes were technical success rate and adverse events (AEs).Results. The clinical success rate of ETGBS was 100%, the technical success rate 94.7%, and AE rate 5%: one patient developed procedure-related mild acute pancreatitis. The clinical courses of all patients were as follows: four died of nonbiliary disease, and the remaining 15 were subsequently treated conservatively. The median duration of follow-up was 14.95 months (range 3–42 months).Conclusions. ETGBS is an effective alternative for managing RC in high-risk patients with severe comorbidities.

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One-year results of gastric peroral endoscopic myotomy for refractory gastroparesis: a French multicenter study

Endoscopy ◽

10.1055/a-1205-5686 ◽

2020 ◽

Author(s):

Olivier Ragi ◽

Jérémie Jacques ◽

Julien Branche ◽

Sarah Leblanc ◽

Geoffroy Vanbiervliet ◽

...

Keyword(s):

Success Rate ◽

Multicenter Study ◽

Clinical Success ◽

Clinical Success Rate ◽

Peroral Endoscopic Myotomy ◽

Gastric Retention ◽

Endoscopic Myotomy ◽

Cardinal Symptom

Abstract Background: Data on the long-term outcomes of gastric peroral endoscopic myotomy (G-POEM) for refractory gastroparesis are lacking. We report the results of a large multicenter long-term follow-up study of G-POEM for refractory gastroparesis. Methods: This was a retrospective multicenter study of all G-POEM operations performed in seven expert French centers for refractory gastroparesis with at least 1 year of follow-up. The primary endpoint was the 1-year clinical success rate, defined as at least a 1-point improvement in the Gastroparesis Cardinal Symptom Index (GCSI). Results: 76 patients were included (60.5 % women; age 56 years). The median symptom duration was 48 months. The median gastric retention at 4 hours (H4) before G-POEM was 45 % (interquartile range [IQR] 29 % – 67 %). The median GCSI before G-POEM was 3.6 (IQR 2.8 – 4.0). Clinical success was achieved in 65.8 % of the patients at 1 year, with a median rate of reduction in the GCSI score of 41 %. In logistic regression analysis, only a high preoperative GCSI satiety subscale score was predictive of clinical success (odds ratio [OR] 3.41, 95 % confidence interval [CI] 1.01 – 11.54; P = 0.048), while a high rate of gastric retention at H4 was significantly associated with clinical failure (OR 0.97, 95 %CI 0.95 – 1.00; P = 0.03). Conclusions: The results confirm the efficacy of G-POEM for the treatment of refractory gastroparesis, as evidenced by a 65.8 % clinical success rate at 1 year. Although G-POEM is promising, prospective sham-controlled trials are urgently needed to confirm its efficacy and identify the patient populations who will benefit most from this procedure.

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

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v11i1.25413 ◽

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.

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Elective Percutaneous Coronary Interventions (PCI) in 100 Cases in a Centre Without On-site Cardiac Surgery Support

Medicine Today ◽

10.3329/medtoday.v24i1.14106 ◽

2013 ◽

Vol 24 (1) ◽

pp. 8-11

Author(s):

Md Nurul Afsar Badrul ◽

Kamal Ahmed ◽

Sufia Rahman

Keyword(s):

Success Rate ◽

Clinical Success ◽

Clinical Success Rate ◽

Hospital Death ◽

Percutaneous Coronary Interventions ◽

Vessel Disease ◽

Coronary Interventions ◽

Percutaneous Coronary ◽

The Mean

Since its introduction in 1977, Percutaneous Coronary Interventions (PCI) is an important tool in the treatment of coronary artery disease (CAD). It is a retrospective analysis of data of 100 cases (132 vessels). The mean age was 50.9 years (range 30-70) with 90 (90%) male and 10 (10%) female. Indication of PCI includes acute and old MI, Chronic stable angina and unstable angina were 48 (48%), 33 (33%) and 19(19%) respectively. Procedure done in total 132 vessels among 100 patients. most of the cases were single vessels disease (SVD) {68 (68%} followed by double vessel disease (DVD) {30(30%)} , triple vessel disease (TVD) {02 (02%)} and chronic total occlusion (CTO) {02 (02%)}.Cobalt chromium was commonly used stent (117 (88.6%) followed by drug illuting stent (DES) 12 (9.1%) and bare metal stent (BMS) 3 (2.3%). Among the site of the stent insertion left anterior descending (LAD) 62 (47%), right coronary lesion (RCA) 37 (28), left circumplex artery (LCX) 33 (25%).Maximum stent length was 35 mm, minimum 10mm. Maximum stent diameter was 3.5 mm whereas minimum diameter 2.5 mm. The mean pretreatment reference diameter was 2.55 ± 0.20 mm and post treatment diameter 2.70 ± 0.45 mm. Angiographic, procedural and clinical success rate were 100%, 98% and 98% respectively. Major adverse cardiovascular event (MACE) {periprocedural MI} occurred in 2 (02 %) cases. Minor cardiovascular complications revealed vascular haematoma 2 (02%), bleeding from access site in 1 (01%), transient ventricular fibrillation (VF) in 3 (03%) cases. There was no hospital death, emergency CABG before discharge from hospital. Angiographic, procedural and clinical success rate were excellent with a little MACE and event free survival within 30 days follow up. So, PCI is a safe and effective method of myocardial revascularization irrespective of lesion morphology and type of stents used at immediate and 30 days follow up. DOI: http://dx.doi.org/10.3329/medtoday.v24i1.14106 Medicine TODAY Vol.24(1) 2012 pp.8-11

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