scholarly journals Use of Triamcinolone Acetonide in External Dacryocystorhinostomy

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Qirat Qurban ◽  
Zeeshan Kamil ◽  
Khalid Mahmood
Keyword(s):  
Success Rate ◽  
Triamcinolone Acetonide ◽  
Nasolacrimal Duct ◽  
Quasi Experimental ◽  
Group A ◽  
Silicone Intubation ◽  
External Dacryocystorhinostomy ◽  
The Difference ◽  
Group B ◽  
External Wound

Purpose:  To study the effect of Triamcinolone Acetonide injection into the ostium through the external wound after one week of external Dacryocystorhinostomy. Study Design:  Quasi experimental study. Place and Duration of Study:  Khalid Eye Clinic, Karachi, from July 2018 to June 2019. Methods:  This study included forty patients with age ranging between 18 to 36 years. All patients had obstruction of the nasolacrimal duct. Patients were categorized into two groups. Both groups underwent external dacryocystorhinostomy with silicone intubation, with the difference being that patients in group A were injected with 20 units of Triamcinolone acetonide 40 mg/ml into the ostium through wound using 27 gauge needle, one week after the surgery. Group B did not receive any injection. Both groups were followed for a period of four months, at which time the silicone tube was removed and patency of lacrimal system was ascertained via syringing with balanced salt solution through the lacrimal puncta. Main outcome measure was the success rate of procedure. Results:  The mean age of the patients was 27.1 ± 5.48 years. Success rate was 100% among the patients of group A and 85% in the patients of group B at the end of the four months followup period. However, the results were statistically insignificant (p = 0.115). Conclusion:  Although statistically insignificant but clinically Triamcinolone Acetonide proved helpful in reducing fibrosis and ostium granuloma formation in patients with Ex-DCR. Thus preventing failure of external Dacryocystorhinostomy. Key Words:  Triamcinolone acetonide, external dacryocystorhinostomy, DCR.

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 Aesthetic Appearance of External Dacryocystorhinostomy Scar: A Comparison between W and C Shaped Incision

2021 ◽  
Vol 37 (3) ◽  
Author(s):  
Zeeshan Kamil ◽  
Qirat Qurban ◽  
Khalid Mahmood
Keyword(s):  
Case Series ◽  
Sampling Technique ◽  
Nasolacrimal Duct ◽  
P Value ◽  
Aesthetic Appearance ◽  
Group A ◽  
External Dacryocystorhinostomy ◽  
The Difference ◽  
Incision Technique ◽  
Group B

Purpose:  To compare the post-operative appearance of external Dacryocystorhinostomy scar resulting from W and C shaped incisions. Study Design:  Interventional case series. Place and Duration of Study:  Khalid eye clinic, Karachi, from July 2018 to June 2019. Methods:  We recruited ninety-six patients of nasolacrimal duct obstruction by convenience sampling technique. Age ranged from 20 to 50 years and both genders were included. Two groups were made. Group A comprised of patients who underwent external Dacryocystorhinostomy (Ex-DCR) surgery through W shaped incision and group B patients underwent Ex-DCR with curvilinear C shaped incision. Main outcome measure was to observe minimal to no visible scarring at wound site after six months of follow up. All patients were explained about the difference in incision technique and consent was obtained from each patient. Results:  Mean age was 34.3 ± 6.897 years. There were thirty-six (37.5%) males and sixty (62.5%) females. Right side was affected in forty-six (47.9%) cases whereas left side was involved in fifty (52.1%) cases. In Group A, 20 (41.6%) out of 48 patients, whereas in Group B, 38 (79.2%) out of 48 patients had no visible scar at all and it was statistically significant with a p-value of < 0.05. Suture abscess developed in four (8.3%) patients in group A, no other serious complications were observed in either group. Conclusion:  Curvilinear C shaped incision in Ex-DCR has better cosmetic outcome. Key Words:  External dacryocystorhinostomy, C shaped incision, W shaped incision.

scholarly journals Comparison of Peri-lesional Triamcinolone Acetonide versus Incision and Curettage in the Treatment of Primary Chalazion

2021 ◽  
Vol 38 (1) ◽  
Author(s):  
Hafiza Sadia Imtiaz ◽  
Aamna Jabran ◽  
Amna Anam ◽  
Wasim Ghous
Keyword(s):  
Experimental Study ◽  
Triamcinolone Acetonide ◽  
Complete Resolution ◽  
Complication Rates ◽  
Gender And Age ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group A ◽  
The Difference ◽  
Group B

Purpose:  To compare the results of peri-lesional Triamcinolone Acetonide (TA) with incision and curettage in the treatment of primary chalazia. Study Design:  Quasi experimental study. Place and Duration of Study:  Eye department of District Head Quarter/Teaching Hospital, Gujranwala, from June 2018 to May 2019. Methods:  One hundred and twenty patients with primary chalazion, either gender and age between 10–30 years, were enrolled in this study. They were equally divided into two groups. In group A, incision and curettage was done. In group B, perilesional TA (40 mg/ml) was given.  Followup was done at 5th day, 14th day, 1 month and 3 months. Lesion resolution or recurrence and complications were recorded. IOP monitoring was also carried out at each followup. Results:  Mean age was 18.0 ± 2.14 years with range of 10–30 years. There were 45.0% females and 55.0% males. No statistically significant difference was found in age, gender and complication rates between the two groups. Complete resolution was seen in 95.0% in group A and 88.3% cases in group B. The difference between the two groups was not statistically significant regarding small and medium sized chalazia. In case of large chalazia, 23 out of 24 patients in group A and 19 out of 23 patients in group B showed complete resolution and the difference in success rate of two groups was statistically significant (p = 0.014). Conclusion:  Incision and curettage and perilesional TA injection are equally effective in treating small and medium primary chalazia. While for large chalazia, Incision and curettage offered superior results. Key words: Chalazion, incision and curettage, triamcinolone Acetonide,

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 Effect of mitomycin C-aided trabeculectomy on conjunctival goblet cell density

1970 ◽  
Vol 4 (1) ◽  
pp. 68-72 ◽  
Author(s):  
S Mukhopadhyay ◽  
SKD Thakur ◽  
J Dutta ◽  
R Prakash ◽  
C Shaw ◽  
...  
Keyword(s):  
Success Rate ◽  
Mitomycin C ◽  
Cell Density ◽  
Goblet Cell ◽  
Deleterious Effect ◽  
Impression Cytology ◽  
Group A ◽  
The Difference ◽  
Group B ◽  
Goblet Cell Density

Introduction: Mitomycin C is gaining widespread popularity as an adjunctive with trabeculectomy, as it significantly increases the success rate of the procedure. But it is associated with serious sight-threatening complications. Materials and methods: Twenty eyes planned for trabeculectomy from the glaucoma clinic were enrolled for the study after obtaining an informed consent. The baseline impression cytology was taken. Ten eyes underwent trabeculectomy with mitomycin C (Group A) and the rest underwent trabeculectomy without any antimetabolites (Group B). Impression cytology samples were taken on months 1, 3, 6, 9 and 12. Results: In Group A, the difference between goblet cell density preoperatively and 12 month postoperatively was statistically significant (p < 0.0001). In Group B, the difference was not statistically significant. (p = 0.27). Conclusion: Mitomycin C, though used to augment the success rate of trabeculectomy, has deleterious effect on the conjunctival goblet cell population as is evident from the conjunctival impression cytology. DOI: http://dx.doi.org/10.3126/nepjoph.v4i1.5854 NEPJOPH 2012; 4(1): 68-72

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 Does concurrent adenoidectomy or tonsillectomy affect the graft success rate of cartilage myringoplasty in adults?

BMC Surgery ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Zhengcai Lou
Keyword(s):  
Success Rate ◽  
Group Differences ◽  
Significant Group ◽  
Hearing Outcome ◽  
Group A ◽  
Study Population ◽  
The Difference ◽  
Graft Success ◽  
Group B ◽  
Hearing Outcomes

Abstract Background The objective of this study was to evaluate the graft success and hearing outcomes of concurrent adenoidectomy or tonsillectomy and myringoplasty. Methods Medical case notes were reviewed for all adult patients with dry perforations who had undergone myringoplasty, with or without concurrent throat surgery, from December 2015 to February 2018. The study population was divided into concurrent myringoplasty and throat surgery (Group A) and single myringoplasty (Group B) groups. The air–bone gap (ABG) and graft success rate were evaluated in both groups. Results A total of 131 ears of 131 patients were included in this study. In total, 33 ears of 33 patients were assigned to Group A and 98 to Group B. Of the 33 patients in Group A, adenoid residue was detected in 3, chronic tonsillitis in 21, and tonsil hypertrophy in 9. The graft success rate was 96.9 % in Group A and 96.9 % in Group B at 6 months postoperatively (p = 0.993). In addition, the graft success rate was 87.9 % in Group A and 92.8 % in Group B at 24 months postoperatively (p = 0.372). Reperforation occurred in three patients in Group A and four in Group B; the difference was not significant. No significant group differences were observed in preoperative (p = 0.654) or postoperative (p = 0.791) ABG values or mean ABG gain (p = 0.439). No patient in either group developed cholesteatoma of the middle ear. Conclusions Simultaneous adenoidectomy or tonsillectomy and myringoplasty is feasible but does not improve the graft success rate or hearing outcome.

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.

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