scholarly journals Trans Canalicular Diode LASER DCR with ‘Bari Device’ in Pediatric Cases

2018 ◽  
Vol 29 (Number 2) ◽  
pp. 8-10
Author(s):  
Md. B B Bhuiyan ◽  
A Akber ◽  
M S Islam ◽  
K U Chowdhury ◽  
M Choudhury
Keyword(s):  
Success Rate ◽  
Pediatric Patients ◽  
Middle Turbinate ◽  
Surgical Techniques ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Endoscopic Dcr ◽  
External Dcr

Epiphora due to Nasolacrimal duct obstruction (NLDO) is common in chidren. About 5% to 20% infants show evidence of congenital Nasolacrimal duct obstruction with symptoms 1,2. Most of them (95%) cured by conservative management. Majority of the remaining symptomatic patients are cured by probing, repeat probing, probing with incubation and Baloonplasty procedures. About 4% of the patients need surgical intervention. Conventional Dacryocystorhinostomy (DCR) is the main treatment of choice in these cases till to date. DCR means creation of an alternate pathway between lacrimal sac and nasal cavity to drain tear when nasolacrimal duct (NLD) is blocked. There are different surgical techniques available for DCR. These includes conventional or external DCR, endoscopic DCR, endoscopic Laser DCR, transcanalicular or endocanalicular Laser DCR. In adult DCR can be carried out comfortably by the conventional or newly developed endoscopic approach. Narrow space, inadequate development of anatomical landmark makes both the conventional & endoscopic DCR difficult in children. Long term success rate of External DCR in pediatric patients is less in comparison to adult due to vigorous growth of tissue in a child. Laser DCR has been tried but long term success rate is not up to the mark. Several observations like- primary osteum closure, cicatrix formation with middle turbinate and nasal septum, granulation tissue formation- all are more in children due to marked fibroblastic response. So Laser DCR is a challenge in pediatric patients.

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.

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 Outcomes of external dacryocystorhinostomy and endoscopic endonasal dacryocystorhinostomy in the management of nasolacrimal duct obstruction

2015 ◽  
Vol 7 (1) ◽  
pp. 39-46 ◽  
Author(s):  
S Duwal ◽  
R Saiju
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Endoscopic Endonasal ◽  
Duct Obstruction ◽  
Dence Interval ◽  
External Dacryocystorhinostomy ◽  
Group 2 ◽  
External Dcr ◽  
Group 1

Introduction: Dacryocystorhinostomy (DCR) is the treatment of choice for nasolacrimal duct obstruction. Although external DCR is regarded as the gold standard, endoscopic DCR is evolving as an equally-effective alternative. Objectives To compare the success rate of treating nasolacrimal duct obstruction by endoscopic endonasal method compared to the conventional DCR surgery.Materials and methods This prospective, comparative, non-randomised study was conducted in 2009 - 2010. Thirty consecutive patients undergoing endoscopic endonasal DCR (Group 1) and 30 consecutive patients undergoing external DCR (Group 2) between July 2009 and September 2010 at the oculoplasty unit of the Tilganga institute of ophthalmology were included in this study. A patent lacrimal passage on syringing and symptomatic improvement at six months after surgery was de¿ned as a successful outcome. The intraoperative and postoperative complications were also compared. Results Our study included 31 eyes of 30 patients in Group 1 and 34 eyes of 30 patients in Group 2. The success rate for endoscopic endonasal dacryocystorhinostomy was 90.3 % (95 % con¿dence interval 80 - 100) and external dacryocystorhinostomy was 94.1 % (95 % con¿dence interval 80 - 100). The difference of surgical success among the two methods was not statistically significant (p = 0.7). The rate of intra-operative and post-operative complications was similar in the two methods (p = 0.5). Conclusion: The short term outcomes and complication rates of endoscopic endonasal dacryocystorhinostomy and external dacryocystorhinostomy were similar.

scholarly journals Role of silicone stenting in endoscopic dacryocystorhinostomy

2020 ◽  
Vol 6 (2) ◽  
pp. 248
Author(s):  
Abdussalam M. Jahan ◽  
Yousef M. Eldanfur ◽  
Abdulhakim B. Ghuzi
Keyword(s):  
Success Rate ◽  
Medical Center ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
P Value ◽  
Success Rates ◽  
Duct Obstruction ◽  
Significant Difference ◽  
Silicone Stent ◽  
Endoscopic Dcr

<p class="abstract"><strong>Background:</strong> Dacryocystorhinostomy (DCR) is a surgical procedure performed to relief nasolacrimal duct obstruction, which involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. Closure of the rhinostomy opening was considered a major factor for surgical failure. Use of silicone stent in endoscopic DCR to improve the success rate of the operation have been tried by many surgeons. In this study we assess the success rates of endoscopic DCR with and without silicone stents.</p><p class="abstract"><strong>Methods:</strong> Prospective study includes 30 patients were operated in the Department of ENT, Misrata Medical Center, from April 2017 to March 2018. They underwent endonasal endoscopic DCR for primary acquired nasolacrimal duct obstruction.<strong> </strong>These patients were randomly divided in two groups: A and B with 15 patients in each group. The group A patients underwent endoscopic DCR with silicone stent and group B patients underwent endoscopic DCR without stent. The results were statistically analyzed by chi-square test.  </p><p class="abstract"><strong>Results:</strong> 30 patients were included in this study, their age ranged from 17 to 60 years, complaining of epiphora, 24 (80%) were females and 6 (20%) were males. The success rate was higher in patients with silicone stent (93.33%) as compared to patients without silicone stent (86.67%) but this difference in the results is not statistically significant (As p value is 0.542 which is &gt;0.05).</p><p><strong>Conclusions:</strong> Endoscopic DCR is safe, successful procedure for treatment of nasolacrimal duct obstruction and there was no significant difference in the success rates of performing endonasal DCR with silicone or without silicone stents.</p>

scholarly journals Endoscopic dacryocystorhinostomy with silicon stent: our experience

2018 ◽  
Vol 4 (3) ◽  
pp. 785
Author(s):  
Neeraj Suri ◽  
Bhavya B. M.
Keyword(s):  
Cost Effective ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Invasive Technique ◽  
Safe Alternative ◽  
Duct Obstruction ◽  
Endoscopic Dacryocystorhinostomy ◽  
Endoscopic Dcr ◽  
Surgical Modality ◽  
External Dcr

<p class="abstract"><strong>Background:</strong> Dacryocystorhinostomy is the current surgical modality of treatment preferred for patients with nasolacrimal duct obstruction. Both external and endonasal endoscopic approaches have been in practice with their own merits and demerits. Since the invention of endoscopes, endoscopic DCR is preferred for its scarless, minimally invasive technique and many modifications have been done over years like placement of silicon stents to reduce recurrence.</p><p class="abstract"><strong>Methods:</strong> In our study we evaluated 70 patients with epiphora with obstruction in nasolacrimal duct, Fresh cases and revision cases who had undergone either external and/ endoscopic DCR without stent were included. All patients underwent endoscopic dacryocystorhinostomy (DCR) with silicon stent placement. Patients were followed postoperatively for a period of 6 months to 3 years.  </p><p class="abstract"><strong>Results:</strong> The results were compared with that of external DCR and endoscopic DCR without stent. In our study we found that, endoscopic DCR with silicon stent had less chances of recurrence and synechiae formation. Results at 3 years follow up have been good with 95.7% patients relieved of symptoms completely.</p><p class="abstract"><strong>Conclusions:</strong> Endoscopic DCR is a cost effective and a safe alternative for External DCR in patients with nasolacrimal duct obstruction. We found that endoscopic DCR with stenting had several advantages over more conventional external approach.</p>

scholarly journals Outcomes and comparison of nasolacrimal probing for patients older than 12 months

2020 ◽  
Vol 12 ◽  
pp. 251584142092713
Author(s):  
Kürsad Ramazan Zor ◽  
Erkut Küçük ◽  
Zeynep Yılmaz Öztorun
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Older Age ◽  
Nasolacrimal Duct Obstruction ◽  
Age Group ◽  
Success Rates ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Initial Surgery ◽  
First Choice

Objective: In this study, we report the results of probing done in our clinic. We also want investigate role of late probing on outcome, especially in children older than 24 and 48 months. Methods: We retrospectively evaluated records of patients who underwent probing under general anaesthesia due to congenital nasolacrimal duct obstruction between 2013 and 2017 in Nigde Ömer Halisdemir University Faculty of Medicine in Nigde, Turkey. Success rates of probing for different age groups were compared. Results: 143 eyes of 123 patients were included in the study. Overall success rate was 93.7% (134 eyes out of 143). We found the success rate as 95.5 in 12–18 months age group, 93.3% in 18–24 months age group, 93.8% in the 24–48 months age group, 86.6% in the 48 months and older age group. Overall success rate in 24 months and older age group was 91.5%. The second operation was performed on seven of the nine patients where the initial surgery failed, and successful results were achieved in six patients. Success rate was 100% after the second surgery in patients older than 48 months. Conclusion: The success rate of probing is high in patients with congenital nasolacrimal duct obstruction from 12 to 84 months. In patients with congenital nasolacrimal duct obstruction who are older than 48 months probing is effective and should be first-choice in this age group in management of congenital nasolacrimal duct obstruction. Probing may be used even in older patients who had previous unsuccessful probing.

Comparison between Endoscopic and External Dacryocystorhinostomy by Using the Lacrimal Symptom Questionnaire: A Pilot Study

2018 ◽  
Vol 32 (1) ◽  
pp. 46-51 ◽  
Author(s):  
Wai Keat Wong ◽  
Simon Dean ◽  
Salii Nair
Keyword(s):  
Quality Of Life ◽  
Social Impact ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
External Group ◽  
Validated Questionnaire ◽  
Endoscopic Group ◽  
External Dcr

Background Epiphora has a significant impact on the patient's quality of life and is commonly caused by nasolacrimal duct obstruction. Dacryocystorhinostomy (DCR) has traditionally been performed via an external approach, which involves a skin incision. With the advent of endoscopes, the endonasal approach to DCR has gained significant popularity. Method To prospectively compare the quality of life of adult patients who underwent either an endonasal or an external DCR for acquired nasolacrimal duct obstruction, the Lacrimal Symptom Questionnaire (Lac-Q) was administered before and after surgery. The treatment group assignment was nonrandom and performed based on patient preference. The Lac-Q is a validated questionnaire that assesses the subjective perception of one's well-being from an eye-specific symptom and social impact standpoint. Total scores range from 0 (no concerns) to 33 (maximal degree of ocular symptoms and social impact). Results Sixty patients (22 in the endonasal group, 38 in the external group) were recruited between January 1, 2014, and January 1, 2016. Postoperative assessment was performed at 3 and 6 months. Patients who underwent external DCR reported a median 7.0–point improvement (interquartile range [IQR], 3.0–11.0) in total Lac-Q scores. A 12.0–point improvement (IQR, 10.0–18.5) was seen in the endonasal group (p = 0.005). The median change in the social impact score was 3.0 and 4.0 in the external group and the endoscopic group, respectively (p = 0.029). Changes in the median lacrimal symptom score were 4.0 in the external group and 8.0 in the endoscopic group (p = 0.014). The anatomic patency rate was lower in the external group (60.0%) when compared with the endonasal group (90.4%). Patients in the external DCR group were significantly older (median age, 51 versus 41 years). Conclusion Our study indicated that both endonasal and external DCR can lead to improvement in quality of life by using a validated questionnaire. Although there are differences in age and anatomic success rates between the two groups, subgroup analyses indicated that the differences in the Lac-Q scores persisted when age and anatomic patency were removed as potential confounding factors. Further larger, randomized studies would be helpful.

Success rates of endoscopic-assisted probing for congenital nasolacrimal duct obstruction in children

2013 ◽  
Vol 127 (8) ◽  
pp. 794-798 ◽  
Author(s):  
S Theodoropoulou ◽  
M S M Sutherland ◽  
K Haddow ◽  
A Blaikie
Keyword(s):  
Success Rate ◽  
Nasolacrimal Duct ◽  
Nasolacrimal Duct Obstruction ◽  
Developmental Abnormality ◽  
Success Rates ◽  
Congenital Nasolacrimal Duct Obstruction ◽  
Duct Obstruction ◽  
Fluorescein Dye ◽  
Age Range ◽  
Test Result

AbstractObjective:To determine the success rate of initial probing in children with congenital nasolacrimal duct obstruction at different ages, using nasal endoscopy.Methods:Fifty eyes of 38 consecutive children with congenital nasolacrimal duct obstruction underwent endoscopic nasolacrimal duct probing under general anaesthesia. Patients were followed up for at least three months. Probing success was defined as complete remission of symptoms and a normal fluorescein dye disappearance test result.Results:The age range of patients was 17–109 months. The success rates of probing were: 100 per cent (29 out of 29) for cases of stenosis at the lower nasolacrimal duct, 100 per cent (7 out of 7) for functional epiphora cases and 92.86 per cent (13 out of 14) for nasolacrimal atresia cases. Overall, there was only one child for whom the probing treatment for nasolacrimal duct obstruction was not successful; this child had Down's syndrome and a more complex developmental abnormality of the nasolacrimal duct. Age and site of obstruction were not found to significantly affect the outcome of probing.Conclusion:Probing of the nasolacrimal system using an endoscopic approach allows direct visualisation of the nasolacrimal duct. This can facilitate diagnosis of the anomaly and significantly increase the procedure success rate.

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