scholarly journals Outcomes of external DCR with primary silicone stent intubation in cases of chronic dacryocystitis

2020 ◽  
Vol 5 (3) ◽  
pp. 34
Author(s):  
SunilG Biradar ◽  
MariamMercy Varghese
Keyword(s):  
Chronic Dacryocystitis ◽  
Silicone Stent ◽  
External Dcr

scholarly journals Early bi-canalicular silicone stent intubation in failed DCR with endoscopic visualization: a combined approach

2019 ◽  
Vol 5 (3) ◽  
pp. 613
Author(s):  
V. Sreenivas ◽  
P. Chaitanya ◽  
Manjoo Reddy
Keyword(s):  
Complete Resolution ◽  
Cost Effective ◽  
Early Postoperative Period ◽  
College Hospital ◽  
Medical College ◽  
Cost Effective Method ◽  
Silicone Stent ◽  
Silicone Intubation ◽  
Endoscopic Dcr ◽  
External Dcr

<p class="abstract"><strong>Background:</strong> Chronic dacryosystitis is a common condition affecting the eye and presenting to ENT surgeons and ophthalmologists, and treated with DCR (dacryocystorhinostomy). In few cases there can be recurrence of symptoms following DCR surgery which can be treated with bi-canalicular silicone intubation. The aim of this study is to assess the effectiveness of an early bi-canalicular silicone intubation in patients with failed DCR using endoscopic visualisation.</p><p class="abstract"><strong>Methods:</strong> This was a prospective observational study. Thirteen cases of DCR operated for chronic dacryocystitis at St John’s Medical College Hospital were reviewed between January 2014 and February 2017. Endoscopic DCR was done for five patients and external DCR for eight patients, number of males were 5 (38%) and females were 8 (62%). Age: 9–73 years (avg: 40.5 years).  </p><p class="abstract"><strong>Results:</strong> Nine patients had complete resolution of symptoms following the primary DCR (4 following external DCR and 5 following endonasal endoscopic DCR). Four patients had failed DCR with persistence of watering three months following primary DCR surgery. Re-DCR with bi - canalicular silicon stent intubation was done in failed cases. Postoperative follow up of all the four patients showed complete resolution of symptoms.</p><p class="abstract"><strong>Conclusions:</strong> Failed DCR surgeries can be effectively intubated using bi–canlicular silicon tubes in the early postoperative period following DCR surgery. Silicone tube intubation is the most safe and cost effective method. Endoscopic visualization gives an added advantage of localizing the cause for a failed DCR.</p>

scholarly journals A Study of Conventional Dacryocystorhinostomy Operation without Silicon Tube Intubation in a Secondary Hospital

2016 ◽  
Vol 10 (1) ◽  
pp. 20-22
Author(s):  
AKM Rafiqul Islam ◽  
Khandaker Anowar Hossain ◽  
Md Abdur Rashid ◽  
Md Amjad Hossain
Keyword(s):  
Inferior Turbinate ◽  
Lateral Wall ◽  
Nasolacrimal Duct ◽  
Atrophic Rhinitis ◽  
Deviated Nasal Septum ◽  
Chronic Dacryocystitis ◽  
Silicon Tube ◽  
Secondary Hospital ◽  
Nasal Pathology ◽  
External Dcr

Dacryocystorhinostomy (DCR) is a bypass surgery in which an anastomosis is made between the medial wall of the lacrimal sac & the lateral wall of the nasal mucosa by cutting the intervening bone at the level of middle meatus to restore the flow of tears when the obstruction is beyond the common canaliculus. The only successful treatment of chronic dacryocystitis is DCR. The aim of this study was to evaluate the surgical intervention of conventional external DCR without silicon tube intubation. This prospective study was conducted at General Hospital, Faridpur from July 2012 to June 2014. Eighty cases with chronic dacryocystitis were selected for the study. We excluded the patients with lacrimal fistula, failed DCR and gross nasal pathology like deviated nasal septum, grossly hypertrophied inferior turbinate, atrophic rhinitis, nasal tumour, and polyp from our study. The patients' mean age at the time of surgery was 41.9±8.1 years ranged from 30 to 60 years. The operation was done under local anaesthesia by applying same technique. Then the patients were followed up for 12 months. In this study, we observed recurrence in five patients (6.25%) and complications from DCR are infrequent and not sight threatening. There were seven patients with reactionary haemorrhage, one wound infection, three wound gap, two epicanthal fold, one granuloma formation and five failed DCR. The success rate is 93.75% who underwent external DCR for the management of epiphora due to nasolacrimal duct obstruction.Faridpur Med. Coll. J. Jan 2015;10(1): 20-22

scholarly journals A Comparative Study between Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy – A Hospital-Based Study

2020 ◽  
Vol 7 (44) ◽  
pp. 2526-2529
Author(s):  
Kanishka Chowdhury ◽  
Sagar Karmakar ◽  
Subhadip Sarkar ◽  
Suman Mukhopadhyay
Keyword(s):  
Invasive Procedure ◽  
External Approach ◽  
Medical College ◽  
Chronic Dacryocystitis ◽  
Group A ◽  
Study Population ◽  
Endoscopic Dcr ◽  
External Dacryocystorhinostomy ◽  
Group B ◽  
External Dcr

BACKGROUND Dacryocystorhinostomy (DCR) can be performed via two approaches either external approach or endonasally. Earlier, external approach was preferred but with the recent introduction of endoscopy, the focus has shifted to endoscopic DCR as it is a less invasive procedure. This study was conducted to compare both the approaches. METHODS 50 patients were selected from patients attending eye and ENT OPD of a medical college in Kolkata with complaints of watering and / or discharge or with other features of chronic dacryocystitis e.g., mucocele, pyocele etc. They were then allocated in to two groups, group A (patients who will undergo endo DCR) and group B (patients who will undergo external DCR). Results of both were compared. RESULTS The mean age of study population was 34.34 ± 6.65 yrs. Among the study population, 36 patients (72 %) were female and 14 were male (28 %). Mean age of Group A (i.e. patients subjected to endo DCR) was 34.60 ± 5.72, while that of Group B (patients undergone external DCR) was 34.08 ± 7.58 yrs. Patients had a right sided predilection for DCR operation (66 %). Most common presenting symptom was epiphora (66 %) followed by epiphora with discharge. Mean time taken for the operation was significantly (p < 0.0001) more in group B (117 ± 14.43 mins) compared to that in group A (46.60 ± 8.63 mins). Massive intraoperative bleeding was more common in group B (32 %) compared to that in group A (p = 0.0023). Group B had a significantly higher rate of post-operative complications (56 %) compared to that in group A (p = 0.00085). Group B also had a higher success rate compared to group A; but this difference was not significant. (p = 0.22144). CONCLUSIONS Both the approaches have their own merits and demerits; but both are accepted alternatives, so either approach could be performed depending on the situation. KEYWORDS Endoscopic DCR, External DCR, Epiphora

scholarly journals Optimization of treatment methods for chronic diseases of the nose and paranasal sinuses combined with chronic dacryocystitis

2019 ◽  
Vol 3 ◽  
Author(s):  
N.J. Khushvakova ◽  
F.A. Nurmukhammedov ◽  
U.F.Davronov
Keyword(s):  
Nasal Cavity ◽  
Chronic Diseases ◽  
Paranasal Sinuses ◽  
Lacrimal Duct ◽  
Treatment Methods ◽  
Chronic Dacryocystitis ◽  
Silicone Stent ◽  
Nose And Paranasal Sinuses

The pathogenesis of the overgrowth of dacryorrhinostoma is based on many factors from the development of granulations and scars in the area of ​​the bone opening to the development of the commissural opening, mucositis in the nasal cavity to purulent persistent forms of rhinosinusitis in the area nose-lacrimal duct. To improve the reparative processes after the operation of endoscopic dacriocystomy with the installation of silicone stent-drainage (from the intubation tube), a zinc hyalrate solution was used.

scholarly journals Comparative Study of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy

2015 ◽  
Vol 8 (1) ◽  
pp. 1-4
Author(s):  
NK Mohindroo ◽  
Harjitpal Singh
Keyword(s):  
Comparative Study ◽  
Mitomycin C ◽  
Average Hospital ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Chronic Dacryocystitis ◽  
Endoscopic Dcr ◽  
External Dacryocystorhinostomy ◽  
Group Ii ◽  
External Dcr

ABSTRACT A prospective study on 50 cases of chronic dacryocystitis was done to see outcome of management by endoscopic dacryocystorhinostomy (DCR) in Indian population and to look for its advantages or disadvantages over external-DCR. Effect of mitomycin-C was also evaluated in endoscopic DCR cases. Dacryocystitis was diagnosed on the basis of clinical examination by doing regurgitation test and lacrimal syringing. These patients were divided into two groups: group I consisted of those 25 subjects who were planned for endonasal endoscopic DCR and group II of those 25 subjects who underwent external-DCR in ophthalmology department. Of all the cases, maximum number of cases was in the age group of 21 to 35 years, 27 (54%) cases, 88% were females and 12% were males. External-DCR required a relatively longer surgical duration of an average 65 minutes as compared to 35 minutes for endonasal DCR. Average hospital stay for patient in group I was 3 days and it was 7 days in group II. There were minimal intraoperative complications in endoscopic procedure as compared to external-DCR group. Average follow-up was 6 months. Primary success rate was 96% in both the groups. Thus, it was concluded that both the procedures represent good alternatives for the treatment of primary nasolacrimal sac or duct obstruction or chronic dacryocystitis, endoscopic DCR having advantage of less complications and less traumatic. Mitomycin-C was found to be helpful in reducing fibrosis. How to cite this article Singh H, Mohindroo NK. Comparative Study of Endonasal Endoscopic Dacryocystorhinostomy and External Dacryocystorhinostomy. Clin Rhinol An Int J 2015;8(1):1-4.

scholarly journals Study of patient outcome in endoscopic dacrocystorhinosomy using a microdebrider in chronic dacryocystitis patients

2020 ◽  
Vol 7 (2) ◽  
pp. 440
Author(s):  
Ankit Vishwani ◽  
H. C. Taneja ◽  
G. K. Das ◽  
Neelima Gupta ◽  
Vipin Arora
Keyword(s):  
Patient Outcome ◽  
Nasolacrimal Duct ◽  
Minimal Amount ◽  
Endoscopic Endonasal ◽  
Chronic Dacryocystitis ◽  
Silicone Stent ◽  
Recent Advancement ◽  
Suitable Treatment ◽  
Endoscopic Dcr

Background: Endoscopic dacryocystorhinostomy (DCR) has become accepted as a suitable treatment for patients with chronic dacryocystitis. In this study authors did endoscopic dacrocystorhinosomy using a microdebrider, which is a recent advancement tool being used successfully in other endoscopic sinus surgeries also. Limited studies are available as of now on this topic.Methods: A total number of 33 patients (with 40 affected eyes) presenting with complains of epiphora having nasolacrimal duct obstruction were selected. They underwent an endoscopic DCR in which dissection of some nasal mucosa and widening of bony ostium was done using a microdebrider. Silicone stent was passed into the nasolacrimal duct through both punctum. Patient outcome was assessed by using both objective (endoscopy and dye test) and subjective (improved symptoms) criteria. Standard follow up time for clinical course was kept 3 months with weekly visits.Results: Patients which got relief from epiphora in 37 eyes (92.5% cases) had no obstruction on endoscopy and positive dye test. Rest (7.5 % cases) had presence of granulation tissue at rhinostoma site and negative dye test, which was cited as the cause of failure.Conclusions: The use of microdebrider is potentially beneficial in endoscopic endonasal dacryocystorhinostomy. By using such an instrument, the minimal amount of tissue damage occurs, a large fistula is formed, and the recurrence due to the formation of adhesions/synechiae/granulations is prevented/reduced thus reducing the time of surgery, complications and failure rate.

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>

scholarly journals Comparative Study Of External And Endoscopic Endonasal Dacryocystorhinostomy For The Treatment Of Chronic Dacryocystitis

2012 ◽  
Vol 7 (2) ◽  
pp. 15-17 ◽  
Author(s):  
MKH Khan ◽  
MA Hossain ◽  
MJ Hossain ◽  
A Al-Masud ◽  
MZ Rahman
Keyword(s):  
Endoscopic Surgery ◽  
Surgical Outcome ◽  
Drainage System ◽  
Endoscopic Endonasal ◽  
Lacrimal Drainage System ◽  
Chronic Dacryocystitis ◽  
Endonasal Dcr ◽  
Endoscopic Dcr ◽  
External Dcr ◽  
Lacrimal Drainage

Introduction: Dacryocystorhinostomy (DCR) is the treatment of choice for Chronic Dacryocystitis. Although external DCR is still regarded as gold standard for acquired naso-lacrimal duct obstruction, endoscopic DCR is evolving as an equally effective alternative in the recent past. Objective: The study was carried out to compare the surgical outcome of external DCR and endoscopic endonasal DCR for the treatment of Chronic Dacryocystitis. Method: This observational study was carried out in the Department of Ophthalmology, Combined Military Hospital, Dhaka from November 2008 to May 2009. A total of 30 consecutive patients were selected for DCR surgery. Among those 15 patients underwent endoscopic endonasal DCR and 15 under went patients external DCR. Data regarding ocular examination, lacrimal drainage system, per-operative and postoperative complications and ultimate surgical outcome were collected and analyzed. Surgical success was defined by patient's resolution of symptoms with patency of lacrimal drainage system. Failure was defined as no symptomatic reduction in epiphora and/or inability to irrigate the lacrimal drainage system postoperatively. Results: Mean age of the patients was 35.0±11.3 years. Fifty three percent of the study subject was male and 43% of the study subject was female. Accumulated result showed that both surgical approaches had almost similar success rate (endoscopic DCR 73.3% versus external DCR 80%; p=0.666). Complication rate was low and no appreciable difference in complication was marked in both types of surgery. Twenty percent in endoscopic DCR group and 13.3% in external DCR group had moderate bleeding. Two patients (13.3%) of endoscopic surgery required septoplasty. All the complications were managed by conservative treatment. Post operative complication particularly nonpatent lacrimal drainage system occurred to 26.7% of endoscopic group and 20% of those with external DCR surgery. Silicon tube was in situ up to 3 months in all the cases. Ultimate failure occurred in 26.7% for endoscopic DCR and 20% for external DCR. Conclusions: Surgical outcome of both endoscopic and external DCR for Chronic Dacryocystitis was quite satisfactory. Overall complication rate was low. Endoscopic surgery might have an advantage of not having any external scar but it requires high equipment cost and long learning curve. DOI: http://dx.doi.org/10.3329/jafmc.v7i2.10389 JAFMC 2011; 7(2): 15-17

scholarly journals Nasolacrimal Obstruction Following the Placement of Maxillofacial Hardware

2020 ◽  
Vol 13 (1) ◽  
pp. 32-37
Author(s):  
J. Minjy Kang ◽  
Evan Kalin-Hajdu ◽  
Oluwatobi O. Idowu ◽  
M. Reza Vagefi ◽  
Robert C. Kersten
Keyword(s):  
San Francisco ◽  
Case Series ◽  
Nasolacrimal Duct ◽  
Maxillofacial Reconstruction ◽  
Institutional Review ◽  
Chronic Dacryocystitis ◽  
External Dacryocystorhinostomy ◽  
The University ◽  
External Dcr

Purpose: This article reviews cases of nasolacrimal obstruction (NLO) secondary to maxillofacial hardware placement. Methods: A retrospective review was performed at a single institution from 2012 to 2017 of patients with NLO following maxillofacial reconstruction. The study was approved by the Institutional Review Board of the University of California, San Francisco, adhered to the tenets of the Declaration of Helsinki, and was Health Insurance Portability and Accountability Act compliant. Patients were included if external dacryocystorhinostomy (DCR) confirmed previously placed maxillofacial hardware as the primary contributor to lacrimal outflow obstruction and had at least 3 months of follow-up. Results: Of 420 patients who underwent external DCR, 6 cases of implant-related NLO were identified. The mean age was 47.3 ± 9.6 years and 66.7% of patients were male. All patients presented with epiphora and 50% also had chronic dacryocystitis. Patients had prior maxillofacial hardware placement for paranasal sinus tumors (66.7%) or facial fractures (33.3%). In addition to external DCR, all patients had revision or removal of implants that were impeding lacrimal outflow by 2 mechanisms: (1) an orbital implant impinging the lacrimal sac or nasolacrimal duct (NLD) and/or (2) maxillofacial screws placed into the bony NLD or nasolacrimal fossa. Five of the 6 patients (83.3%) had complete resolution of symptoms and patency of the nasolacrimal system at their last follow-up visit (range 3-30 months). Conclusion: NLO secondary to hardware placement, though infrequent, is underreported. Two mechanisms of hardware-induced NLO were encountered in this case series. Specific attention to nasolacrimal anatomy at the time of maxillofacial reconstruction may help minimize implant-induced NLO.

scholarly journals Endoscopic Dacryocystorhinostomy: Advantage over External Approach

2019 ◽  
Vol 27 (2) ◽  
pp. 161-166
Author(s):  
Bijan Basak ◽  
Kaustuv Das Biswas ◽  
Subhradev Biswas ◽  
Ankit Choudhary
Keyword(s):  
Standard Treatment ◽  
Nasolacrimal Duct ◽  
External Approach ◽  
Interventional Study ◽  
Safe Alternative ◽  
Endoscopic Dacryocystorhinostomy ◽  
Chronic Dacryocystitis ◽  
Endoscopic Dcr ◽  
Prospective Longitudinal ◽  
External Dcr

Introduction Although external DCR was considered to be the Gold Standard treatment for NLD obstruction, endoscopic DCR appears to give comparable results,  with the advantage of the absence of external facial scar and no disruption of the medial palpebral ligament or the angular facial vessels. This study aims to evaluate the outcome of endoscopic dacryocystorhinostomy (DCR) and compare with the outcome of external DCR, based on data available on literature search. Materials and Methods In this prospective, longitudinal, interventional study, 67 cases of chronic dacryocystitis were operated endoscopically from January 2017 to December 2018. All patients were documented about detailed medical and operative history, thorough medical check up including ocular and ENT examination. Level of obstruction of nasolacrimal duct (NLD) was diagnosed by lacrimal syringing and probing. Surgery was performed under local anaesthesia except in uncooperative patients where general anaesthesia was used. 0˚ & 30˚ endoscopes were used in surgery. The surgical outcomes and complications were recorded, analyzed and compared to those of external DCR from available literature.   Results The overall success rate of endoscopic DCR was 94.7%, which is closely comparable to external DCR. Conclusion Endoscopic DCR is an effective and safe alternative to external DCR, with comparable results and better patient satisfaction.

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