Outcome of Endonasal Dacryocystorhinostomy with Nasal and Lacrimal Sac Mucosal Flaps

Purpose: In patients with nasolacrimal duct obstruction, the outcomes of surgery were evaluated according to the type or presence of flaps. Methods: In total, 509 eyes were compared retrospectively: 178 eyes in patients treated without flaps, 126 eyes in patients treated using nasal mucosa flaps, and 205 eyes in the patient group using nasal and lacrimal sac mucosal flap were compared retrospectively. We analyzed the factors of success according to the surgical method by comparing granulation and bony ostium obstruction at 1, 3, and 6 months after surgery in each group. Results: At 6 months after surgery, granulation was found in 6 eyes (2.93%) in the nasal and lacrimal sac mucosal flap group, 5 eyes (3.96%) in the nasal mucosal flap group, and 15 eyes (8.42%) in the group treated without flaps. Bony ostium obstruction was found in 3 eyes (1.46%) in the nasal and lacrimal sac mucosal flap group, 4 eyes (2.38%) in the nasal mucosal flap group, and 6 eyes (2.81%) in the group treated without flaps. The anatomical surgical success rate of patients treated with nasal and lacrimal sac mucosal flaps was 95.61%, which was higher than those of patients treated with nasal mucosal flaps (92.86%) and without flaps (88.20%). The functional and anatomical surgical success rate was 94.15% in the group treated with nasal and lacrimal sac mucosal flaps, 88.89% in the group treated with nasal mucosal flaps, and 84.83% in the group treated without flaps. Conclusions: Endonasal dacryocystorhinostomy using the nasal and lacrimal sac mucosal flap is an effective method that minimizes the risk of granulation and bony ostium obstruction.

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Analysis of Age as a Possible Prognostic Factor for Transcanalicular Multidiode Laser Dacryocystorhinostomy

Journal of Ophthalmology ◽

10.1155/2014/913047 ◽

2014 ◽

Vol 2014 ◽

pp. 1-5 ◽

Cited By ~ 1

Author(s):

Emre Ayintap ◽

Ibrahim Bulent Buttanri ◽

Fariz Sadıgov ◽

Didem Serin ◽

Mustafa Ozsutcu ◽

...

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Skin Incision ◽

Old Patients ◽

Surgical Success ◽

Group 4 ◽

Group 3 ◽

Group 5 ◽

Group 2 ◽

Group 1

Purpose. To assess the prognostic value of age on the outcome of transcanalicular multidiode laser dacryocystorhinostomy (TCL-DCR) in patients with acquired nasolacrimal duct obstruction (NLDO).Methods. The medical records of TCL-DCR performed between March 2009 and September 2013 were reviewed retrospectively. Inclusion criteria include over 20 years of age, similar mean follow-up period, and similar mean duration of stenting. The main outcome is surgical success. The effect of age on success rate is also evaluated.Results. The anatomical success was 52% in Group 1 (20–30 years), 56% in Group 2 (31–40 years), 64% in Group 3 (41–50 years), 76% in Group 4 (51–60 years), and 88% in Group 5 (over 60 years). The statistical difference among Group 1 and Group 5, in terms of surgical success rate, was found to be significant (P=0.009). Additionally, the 20–30-year-old patients had a failure rate 6.76 times higher than that of the over-60-year-old patients (P=0.009; 95% CI, 1.605–28.542).Conclusion. TCL-DCR is a surgical treatment option for NLDO for which a skin incision can be avoided. The success rate of TCL-DCR for younger population is lower when compared with elderly population.

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Balloon Dacryocystoplasty with Pushed Monocanalicular Intubation as a Primary Management for Primary Acquired Nasolacrimal Duct Obstruction

10.21203/rs.3.rs-752605/v1 ◽

2021 ◽

Author(s):

Chun-Chieh Lai ◽

Cheng-Ju Yang ◽

Chia-Chen Lin ◽

Yi-Chun Chi

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Combination Group ◽

Duct Obstruction ◽

Surgical Success ◽

Significant Difference ◽

Silicone Stent ◽

Primary Management ◽

Monocanalicular Intubation

Abstract Though dacryocystorhinostomy (DCR) has long served as the gold treatment for primary nasolacrimal duct obstruction (PANDO), balloon dacryocystoplasty (DCP) and silicone stent intubation were applied especially in partial PANDO in the attempts to avoid osteotomy and reduce invasiveness. Herein, we present the results of the combined procedures with balloon DCP and pushed monocanalicular intubation in complete PANDO, and comparison of the combination to balloon DCP alone. We retrospectively reviewed 72 eyes of 56 patients, including 37 eyes of 29 patients in the combination group and 35 eyes of 28 patients in the balloon DCP alone group. There was no significant difference in the success rate between antegrade balloon DCP with and without pushed MCI in general. Nevertheless, interestingly the former procedure was associated with significantly higher surgical success rate than the latter in younger patients.

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Surgical success rate comparison in functional nasolacrimal duct obstruction: simple lacrimal stent versus endoscopic versus external dacryocystorhinostomy

European Archives of Oto-Rhino-Laryngology ◽

10.1007/s00405-012-2014-7 ◽

2012 ◽

Vol 270 (2) ◽

pp. 535-540 ◽

Cited By ~ 15

Author(s):

Won-Kyung Cho ◽

Ji-Sun Paik ◽

Suk-Woo Yang

Keyword(s):

Success Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Surgical Success ◽

External Dacryocystorhinostomy ◽

Rate Comparison

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Endonasal dacryocystorhinostomy without stents: our experience

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20173123 ◽

2017 ◽

Vol 3 (4) ◽

pp. 932

Author(s):

Preeti S. Raga ◽

Amrith Laal Waghre

Keyword(s):

Success Rate ◽

Patency Rate ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Lacrimal Sac ◽

Duct Obstruction

Background: Dacryocystorhinostomy (DCR) for the treatment of nasolacrimal duct obstruction. The aims of the study were to assess the patency rate of endoscopic (ED DCR) using a technique similar to that described by McDonogh and Meiring but without the use of nasolacrimal silicone stents. Methods: Endonasal dacryocysto-rhinostomies (ED DCRs) were performed without the use of silicone stents in 46 patients (20 male, 26 female). These patients were followed up for an average of eight months. Results: The procedure was successful in 86.95% of cases as measured by patient’s relief of symptoms and endoscopic visualization of a middle meatal ostium draining the lacrimal sac. Conclusions: In our study ED DCR without stents had less complications and also a success rate of 86.95% achieved when compared with DCR with stents.

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Efficacy of mitomycin c in endoscopic dacryocystorhinostomy

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20184355 ◽

2018 ◽

Vol 4 (6) ◽

pp. 1431

Author(s):

Vinod Shinde ◽

Anju Unnikrishnan ◽

Shad Fatma ◽

James Thomas

Keyword(s):

Mitomycin C ◽

Nasolacrimal Duct ◽

Lacrimal Sac ◽

Duct Obstruction ◽

Surgical Success ◽

Endoscopic Dacryocystorhinostomy ◽

Nasal Sprays ◽

Group I ◽

Chronic Dacryocystitis ◽

Cause Of Failure

Background: Endoscopic dacryocystorhinostomy is a procedure done to drain the lacrimal sac due to post saccular lacrimal obstruction. The most common cause of failure of dacryocystorhinostomy is blockage of ostium created in lacrimal sac. Various methods are employed to prevent the blockage such as stenting, mitomycin C and steroidal nasal sprays. In this study we evaluated the efficacy of mitomycin C in reducing the stomal closure following dacryocystorhinostomy.Methods: Fifty patients who were diagnosed with chronic dacryocystitis due to nasolacrimal duct obstruction were chosen for the study. They were randomly divided in to two groups. In group I 25 patients under went endoscopic dacryocystorhinostomy with intraoperative mitomycin C application and in group II 25 patients underwent endoscopic dacryocystorhinostomy without application of mitomycin C. Patients were followed up at the end of one week, three weeks, three months and six months. Surgical success was evaluated objectively at the end of six months. Results: The success rate of endoscopic dacryocystorhinostomy with use of mitomycin c was 86% in group where mitomycin c was used and 62% in group where mitomycin c was not used.Conclusions: Mitomycin C is a safe drug which can keep the stoma created patent and reduces the chance of recurrence following endoscopic dacryocystorhinostomy.

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Endoscopic dacryocystorhinostomy without mucosal flap : Our experience

Bangladesh Journal of Otorhinolaryngology ◽

10.3329/bjo.v19i1.11728 ◽

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

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External Dacryocystorhinostomy and Patient Satisfaction: Perspective of General Ophthalmologist

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v13i2.31701 ◽

2021 ◽

Vol 13 (2) ◽

pp. 21-29

Author(s):

Suresh BK Rasaily ◽

Kaushal Pokharel ◽

Sulaxmi Katuwal ◽

Sabita Bishowkarma ◽

Ben Limbu ◽

...

Keyword(s):

Patient Satisfaction ◽

Success Rate ◽

Case Series ◽

Subscale Score ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

Surgical Success ◽

Glasgow Benefit Inventory ◽

External Dacryocystorhinostomy

Introduction: This study aimed to evaluate patient satisfaction over time in patients undergoing external dacryocystorhinostomy for primary nasolacrimal duct obstruction when done by a general ophthalmologist. Materials and methods: This prospective interventional case series was done in a secondary level eye hospital in the Midwestern region of Nepal from 1st January 2018 to 30th December 2018. Fifty-four consecutive adult patients diagnosed with primary nasolacrimal duct obstruction who underwent external dacryocystorhinostomy performed by a general ophthalmologist were included. The surgical success rate was determined at six months on the basis of the resolution of symptoms with patency on syringing. Postoperative patient satisfaction was evaluated 6 months after surgery with a standardized Glasgow Benefit Inventory and post-intervention questionnaire. Results: A total of 54 eyes were operated on within the study period and a larger number of surgeries were done in the age group 26-30 years. Female constituted 79.6 % and male 20.4% with a ratio of 3.9:1. Overall surgical success rate 6 months after surgery was 96.30%. The mean total Glasgow benefit inventory (GBI) score was 48.83 ± 23.87 (95% CI, 42.96- 56.95), mean general subscale score was 52.70± 23.28 (95% CI, 46.49-60.38), social support subscale was 49.69 ± 44.68 (95% CI, 41.15-60.35) and physical health subscale score was 37.07 ± 41.19 (95% CI, 27.48-49.26). Conclusion: The external dacryocystorhinostomy surgeries performed by general ophthalmologists achieved an excellent surgical success rate and good patient satisfaction proven by a validated questionnaire.

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Clinicopathologic Study of Lacrimal Sac and Nasal Mucosa in 44 Patients with Complete Acquired Nasolacrimal Duct Obstruction

Ophthalmic Plastic and Reconstructive Surgery ◽

10.1097/00002341-199203000-00002 ◽

1992 ◽

Vol 8 (1) ◽

pp. 13-21 ◽

Cited By ~ 56

Author(s):

Joseph A. Mauriello ◽

Severin Palydowycz ◽

Joseph DeLuca

Keyword(s):

Nasal Mucosa ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Lacrimal Sac ◽

Duct Obstruction ◽

Clinicopathologic Study

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

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20204624 ◽

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

Background: 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.Methods: 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). Results: 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.Conclusions: 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.

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