Mitomycin C in Revision Endoscopic Dacryocystorhinostomy: A Prospective Randomized Study

2011 ◽  
Vol 25 (6) ◽  
pp. 425-428 ◽  
Author(s):  
Elina Penttilä ◽  
Grigori Smirnov ◽  
Juha Seppa ◽  
Kai Kaarniranta ◽  
Henri Tuomilehto
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Randomized Study ◽  
Study Groups ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Prospective Randomized Study ◽  
Safe Procedure ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy

Background Endoscopic dacryocystorhinostomy (EN-DCR) is an effective and safe procedure when treating saccal and postsaccal nasolacrimal duct obstruction. However, sometimes scarring of the rhinostomy site caused by fibrosis may occur, particularly in revision operations. The application of intraoperative mitomycin C (MMC), an antiproliferative agent, has been introduced as one possible technique to improve the outcome. We conducted a prospective, randomized study to evaluate if the use of MMC improves the success in endonasal revision DCR procedure. Methods Thirty revision EN-DCR procedures were performed during 2004–2010. The patients were randomized into two study groups, according to whether the intraoperative MMC was used or not. The technique of EN-DCR procedure in both groups was the same, but in the MMC group, at the end of the procedure a piece of tampon soaked in MMC (0.4 mg/mL) was placed into the rhinostoma for 5 minutes. No silicone stents were inserted. The surgical outcome at the 6-month follow-up visit was considered successful if the lacrimal sac irrigation succeeded and if the patients’ symptoms were relieved. Results The success rate after revision EN-DCR with MMC was 93% and without MMC was 60%. The overall success rate was 77%. The difference between the two groups was not statistically significant (p = 0.08). The relief of the symptoms between groups in both the Nasolacrimal Duct Obstruction Symptom Score and ocular symptoms was statistically significant (p = 0.007 and p = 0.02, respectively). Conclusion The results of our study indicate that the application of intraoperative mitomycin C may improve the outcome in revision EN-DCR.

scholarly journals Bilateral Simultaneous Endoscopic Dacryocystorhinostomy: Outcome and Impact on the Quality of Life of the Patients

2019 ◽  
Vol 23 (02) ◽  
pp. 191-195
Author(s):  
Islam R. Herzallah ◽  
Osama A. Marglani ◽  
Ameen Z. Alherabi ◽  
Nuha S. Faraj ◽  
Deemah H. Bukhari
Keyword(s):  
Quality Of Life ◽  
Success Rate ◽  
Symptom Score ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Safe Procedure ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Significant Difference

Introduction Bilateral simultaneous endoscopic dacryocystorhinostomy (endo-DCR) has received little attention in the literature, thus many surgeons continue to address bilateral nasolacrimal duct obstruction at two stages, rather than in the same setting. Objective To evaluate the feasibility and the outcome of simultaneous bilateral Endo-DCR and its impact on the quality of life of the patients. Methods We have conducted a retrospective analysis of patients who underwent bilateral simultaneous endo-DCR between March 2013 and February 2017 at our tertiary care institution. The reviewed data included clinical presentation; operative details; success rate; pre and postoperative evaluation of the symptoms of the patients, using the Nasolacrimal Duct Obstruction Symptom Score Questionnaire; satisfaction of the patients, and improvement in the quality of life, assessed by the Glasgow Benefit Inventory (GBI) questionnaire. Results Out of 128 cases in which endo-DCRs were performed, 13 were bilateral (26 sides). Postoperative success was documented in 24 of the 26 sides (92.3%), with a mean follow-up duration of 16.2 months. The two failed sides were reported in the same case. The preoperative symptom score ranged between 12 and 80 (mean ± standard deviation [SD]: 38.23 ± 15.7). The postoperative symptom score was significantly lower (mean ± SD: 5.4 ± 12.9). The success rates in unilateral and bilateral cases were comparable, with no statistically significant difference. A notable improvement in the quality of life of the patients was also reported, with a mean GBI score of 81.38 ± 12.37. Conclusion Our results support that a simultaneous bilateral endo-DCR is a safe procedure that offers a high success rate, spares the patient from the stress of a second surgery, provides the patient with a bilateral resolution of the symptoms, and confers an immediate improvement in the quality of life of the patients.

scholarly journals Successes rate of endoscopic dacryocystorhinostomy at KMC

1970 ◽  
Vol 8 (2) ◽  
pp. 195-198 ◽  
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

scholarly journals Endoscopic dacryocystorhinostomy for nasolacrimal duct obstruction: an assessment of post-operative outcomes at a tertiary health care centre

2021 ◽  
Author(s):  
R. K. L. N. Raju Dantuluri
Keyword(s):  
Health Care ◽  
Success Rate ◽  
Drainage System ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Deviated Nasal Septum ◽  
Health Care Centre ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Operative Outcomes

Background: Endoscopic dacryocystorhinostomy (Endo DCR) is a well-established surgical treatment for nasolacrimal duct obstruction (NLDO) cases. Advances in surgical technique and a better understanding of the anatomy have resulted in improvement of the success rate. The objective of this study is to assess the factors responsible for the recurrence of nasolacrimal system obstruction by evaluating the post-operative outcomes of Endo DCR at a tertiary health care centre.Methods: A retrospective study was conducted in the department of ENT, GVP IHC and MT, Visakhapatnam – Andhra Pradesh on 52 patients who underwent Endo DCR procedure from September 2018 to September 2021. The data regarding lacrimal drainage system, operative details, surgical outcomes and complications were analysed.Results: Fifty-two patients (18 male and 34 female) underwent 63 Endo DCR surgeries for NLDO. Success was achieved in 50 cases (79.4%), and failure in 13 (20.6%). Of the 13 failed cases, anatomical obstruction at the fistula site was found in 6 (46.2% of failed cases), whereas functional failure with no evidence of obstruction was found in 7 (53.8%).Conclusions: The success rate appears to be influenced by preoperative parameters like clinical as well as radiological examination of eye and nose; ruling out intraoperative conditions like sinusitis, deviated nasal septum, polyps. These are essential for better coordinating therapeutic expectations and better patient selection. Endo DCR proved to be a safe invasive procedure as it has direct approach to the sac and produced excellent results without any external scar.

Endoscopic dacryocystorhinostomy with circumostial mitomycin C injection, simultaneous limited septoplasty and the use of tissue glue

2020 ◽  
Vol 13 (9) ◽  
pp. e235565
Author(s):  
Rafal Nowak ◽  
Iwona Nowak
Keyword(s):  
Mitomycin C ◽  
Nasolacrimal Duct ◽  
Observation Time ◽  
Septal Deviation ◽  
Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Tissue Glue

Epiphora due to nasolacrimal duct obstruction is a common condition worsening one’s quality of life. It requires surgical treatment. We present a combined technique of transnasal endoscopic dacryocystorhinostomy with simultaneous limited septoplasty, circumostial mitomycin C injection and the use of tissue glue in a case of a 72-year-old patient with nasolacrimal duct obstruction complicated by septal deviation. The multiprocedure surgery was performed successfully. Follow-up time was 2 years. The patient remained asymptomatic within the observation time. Functional and anatomical success was achieved. We believe that the transnasal endoscopic dacryocystorhinostomy extended by limited endoscopic septoplasty, circumostial mitomycin C injection and the use of fibrin glue may be a solution for selected cases of nasolacrimal obstruction accompanied by significant local septal deviation.

scholarly journals Endoscopic dacryocystorhinostomy without mucosal flap : Our experience

2013 ◽  
Vol 19 (1) ◽  
pp. 41-45
Author(s):  
Nagendran Navaneethan
Keyword(s):  
Success Rate ◽  
Retrospective Review ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Nasal Endoscopy ◽  
Subjective Improvement ◽  
Mucosal Flap ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Diagnostic Endoscopy

Background: The purpose of our study was to evaluate outcome of Endoscopic dacryocystorhinostomy without preservation of mucosal flap for the management of acquired nasolacrimal duct obstruction Methods: A retrospective review of 26 patients were performed on patients who underwent Endoscopic dacryocystorhinostomy without preservation of mucosal flap from March 2007 to November 2010 at our hospital. Twenty six patients were operated and followed up postoperatively for five to six weeks with lacrimal syringing by ophthalmologists and diagnostic endoscopy done at third month and followed up until the formation of well formed ostium and patients became asymptomatic. Main outcome were subjective improvement in epiphora and persistence of anatomic patency of ostium. Result: There were 26 patients operated, one is male and all others were female. The age of patients were ranging within 20 to 78 years (mean 36.65years).Every patients were followed up in the range of four months to two years (mean 6.2 months). Septoplasty was required in only one patient prior to DCR. Anatomic patency were confirmed by nasal endoscopy in twenty four patients (92%), remaining two had synechiae without ostium. One patient among 24 patients had ostium and lacrimal flow with intermittent epiphora. Our overall success rate with anatomical patency and without symptoms of epiphora is 88%. Conclusion: Our results with endoscopic dacryocystorhinostomy are comparable with previously published outcomes. Our data suggest that endoscopic dacryocystorhinostomy without preservation of mucosal flap may be performed DOI: http://dx.doi.org/10.3329/bjo.v19i1.11728 Bangladesh J Otorhinolaryngol 2013; 19(1): 41-45

scholarly journals Outcomes of Conventional External Dacryocystorhinostomy with and without Mitomycin C: Experience from Eastern Nepal

2020 ◽  
Vol 12 (2) ◽  
pp. 209-215
Author(s):  
Simanta Khadka ◽  
Purushottam Joshi ◽  
Prava Subedi Basnet ◽  
Chandni Pradhan
Keyword(s):  
Adverse Drug Reaction ◽  
Drug Reaction ◽  
Success Rate ◽  
Mitomycin C ◽  
Financial Burden ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Post Surgery ◽  
External Dacryocystorhinostomy

Introduction: Dacryocystorhinostomy (DCR) is the commonest surgery for nasolacrimal duct obstruction. Inhibition of the scarring process within the anastomosis and rhinostomy site which has been attributed to the failure of this procedure, might improve the success rate of DCR. The objective of this study was to evaluate the outcomes of DCR with Mitomycin-C (MMC) and to compare the results of DCR with and without MMC. Materials and methods: A hospital based, prospective study was conducted in patients with primary acquired nasolacrimal duct obstruction. Standard conventional DCR was performed upto the level of creation of flaps. Application of MMC 0.2 mg/ml in and around the ostium and underneath the created flaps for two minutes was effected with cotton pledgets. The area was thoroughly washed with normal saline after removal of the pledgets. Rest of the surgery was completed as usual. The patients were followed up on the first postoperative day, one month and three months post surgery. Results: A total of 60 cases, 30 in each group were allocated. The success rate of DCR with MMC was found to be 96.7% compared to 86.7% (p=0.35) in the DCR group at the end of three months duration. Conclusions: Intraoperative application of MMC during conventional DCR surgery provides a comparatively higher success rate than DCR without MMC without posing any extra financial burden and adverse drug reaction to the patient.

scholarly journals Role of mitomycin-C in endoscopic dacryocystorhinostomy with lacrimal sac stenting

2020 ◽  
Vol 6 (11) ◽  
pp. 2017
Author(s):  
Jogeshwar Singh ◽  
Manish Munjal ◽  
Sanjeev Puri ◽  
Parth Chopra ◽  
Shubham Munjal ◽  
...  
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Nasolacrimal Duct ◽  
Study Group ◽  
Lacrimal Sac ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Primary Success

<p class="abstract"><strong>Background:</strong> This study critically evaluates the effectiveness of mitomycin-C in conventional endoscopic dacryocystorhinostomy (ENDODCR) that minimizes the reclosure of a neo-ostium by retaining an enlarged marsupialized lacrimal sac.</p><p class="abstract"><strong>Methods:</strong> The combined retrospective and prospective study included 24 patients in the study group, who underwent endoscopic dacryocystorhinostomy in the Department of Otorhinolaryngology and Ophthalmology in a period of 1.5 years (June 2006 to January 2008).  </p><p class="abstract"><strong>Results:</strong> An 83.33% primary success rate was observed, without any serious complications. Obstruction of the neo-ostium with granulation tissue was observed in 20.83% cases. Overall, the success rate of group I was 91.67% as compared to 75% in group II.</p><p class="abstract"><strong>Conclusions:</strong> Intra operative mitomycin-C application is effective in increasing the success rate of DCR surgery in standard nasolacrimal duct obstruction, and no significant complications resulted from its use.</p>

scholarly journals External dacryocystorhinostomy

2019 ◽  
Vol 16 (3) ◽  
pp. 179-185
Author(s):  
Li Ying Long ◽  
Safinaz Mohd Khialdin ◽  
Nazila Binti Ahmad Azli
Keyword(s):  
Surgical Technique ◽  
Success Rate ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Retrospective Case ◽  
Duct Obstruction ◽  
Posterior Flap ◽  
External Dacryocystorhinostomy ◽  
External Dcr

Aim: To analyse the epidemiological data, surgical technique, success rate, and complications of patients who underwent external DCR in Hospital Selayang from January 2015 to December 2016. Method: Retrospective case series. Results: A total of 21 eyes of 20 patients who underwent external DCR from January 2015 to December 2016 were identified and reviewed. There were 15 females (75%) and 5 males (25%). Age ranged from 5 to 75 years old, with a median age of 56 years old (IQR 23). Twelve patients presented with epiphora while eight patients presented with symptoms of dacryocystitis. One case was congenital, two were secondary nasolacrimal duct obstruction and the rest were primary nasolacrimal duct obstruction. All patients underwent external DCR under general anaesthesia. Silicone tube were inserted in 21 eyes, of which all were removed 3 months after the surgery except one patient whom had his tube dislodged accidentally. The overall success rate was 90.5% (n = 19), which was defined as no or minimal intermittent epiphora or no reflux on lacrimal irrigation at 12 months postoperative. There was one patient who had a cerebrospinal fluid leak treated successfully with intravenous antibiotics. Conclusion: The surgical success rate for external dacryocystorhinostomy was comparable to that of the global success rate of external DCR. This is attributed to the application of surgical technique such as anterior suspended flap modification and posterior flap excision.

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