ENDOSCOPIC ENDONASAL DACRYOCYSTORHINOSTOMY: EXPERIENCE OF HUNDRED CASES

Objective: To determine the success rate of Endonasal Endoscopic Dacryocystorhinostomy (Endo-DCR) in cases of chronic dacryocystitis secondary to primary acquired nasolacrimal duct obstruction (NLDO). Study Design: Quasi-experimental study. Place and Duration of Study: Department of Oculoplastic Surgery, Armed Forces Institute of Ophthalmology Rawalpindi, from Sep 2018 to Nov 2019. Methodology: Endo-DCR under General Anaesthesia was performed on 100 patients of primary acquired nasolacrimal duct obstruction causing chronic dacryocystitis. Post-operatively these patients were checked on first post-op day, then on one week and finally four months after surgery. We removed silicone tubes of all the patients four months after surgery. To ensure patency of lacrimal passage, we did syringing and irrigation of lacrimal system of all cases, at conclusion of the study. We chose absence of epiphora and patent lacrimal system on syringing as indicators of successful procedure. Results: Hundred patients (males 37; females 63) were recruited for this study. Mean age of our sample population was 51.1 ± 29 years. Right nasolacrimal duct obstruction cases were 56 whereas left nasolacrimal duct obstruction cases were 44. Subjective improvement i.e., absence of epiphora was found in 90% patients. We got successful irrigation of lacrimal passages (objective improvement) in 94% of patients. Conclusion: Endo-DCR yields comparable results to external Dacryocystorhinostomy (Ex DCR). It offers additional benefits of esthetically better outcome, lesser complication rate and short surgery and patient recovery time.

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Non endoscopic endonasal dacryocystorhinostomy versus external dacryocystorhinostomy

Kathmandu University Medical Journal ◽

10.3126/kumj.v6i4.1731 ◽

1970 ◽

Vol 6 (4) ◽

pp. 437-442 ◽

Cited By ~ 9

Author(s):

BR Sharma

Keyword(s):

Direct Method ◽

Case Series ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Successful Outcome ◽

Success Rates ◽

Endoscopic Endonasal ◽

Duct Obstruction ◽

Surgical Success ◽

External Dacryocystorhinostomy

Aims and Objectives: To compare the success rates of non endoscopic endonasal dacryocystorhinostomy and conventional external dacryocystorhinostomy for the surgical management of primary acquired nasolacrimal duct obstruction. Materials and methods: A retrospective, nonrandomized, comparative interventional case series of 302 patients who underwent either endonasal or external dacryocystorhinostomy over a period of 2 years. All surgeries were performed by a single surgeon and patients with primary nasolacrimal duct obstruction with a minimum of 6 months post operative follow up were included in the study. While external dacryocystorhinostomy was performed using traditional technique, endonasal dacryocystorhinostomy was performed using direct method of nonendoscopic visualization. Results: Of the 302 cases included in the study 165 patients had endonasal dacryocystorhinostomy whereas 137 underwent external dacryocystorhinostomy. Success was defined by resolution of symptoms of tearing, a negative fluorescein dye disappearance test and patency of the canalicular system on lacrimal irrigation. In the external dacryocystorhinostomy group 124 (90.5%) patients had surgical success whereas 146 (88.5%) of the endonasal dacryocystorhinostomy patients had successful outcome. The overall success rate was 89.4%, and the difference of surgical success between the two groups was not statistically significant ( P=0.57). Conclusion: Non endoscopic endonasal dacryocystorhinostomy gives surgical results comparable to those of external dacryocystorhinostomy and is a viable alternative where dacryocystorhinostomy is indicated for primary acquired nasolacrimal duct obstruction. Key words: Endonasal Dacryocystorhinostomy (ENDCR), External Dacryocystorhinostomy (EXDCR), Primary acquired nasolacrimal duct obstruction (PANLDO) doi: 10.3126/kumj.v6i4.1731 Kathmandu University Medical Journal (2008), Vol. 6, No. 4, Issue 24, 437-442

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

Nepalese Journal of Ophthalmology ◽

10.3126/nepjoph.v7i1.13165 ◽

2015 ◽

Vol 7 (1) ◽

pp. 39-46 ◽

Cited By ~ 3

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.

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Transcanalicular diode laser assisted dacryocystorhinostomy: A breakthrough in the treatment of acquired nasolacrimal duct obstruction

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.36.4.1906 ◽

2020 ◽

Vol 36 (4) ◽

Author(s):

Muhammad Awais ◽

Syed Abid Hassan Naqvi ◽

Amjad Akram ◽

Muhammad Shahid

Keyword(s):

Success Rate ◽

Diode Laser ◽

Armed Forces ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Invasive Technique ◽

Duct Obstruction ◽

Creative Commons ◽

Quasi Experimental ◽

Good Cosmetic

Objective: To evaluate the success rate of Transcanalicular Diode laser assisted Dacryocystorhinostomy (TC-DCR) in cases of acquired nasolacrimal duct obstruction (NLDO). Methods: This Quasi-Experimental study was conducted in Armed Forces Institute of Ophthalmology (AFIO) Rawalpindi, from July 2018 to April 2019. In this study, 73 patients of chronic dacryocystitis secondary to acquired NLDO were treated by TC-DCR under general anaesthesia. Follow up examination was done after one day, one week and three months. Silicone tubes were removed three months after surgery and syringing of lacrimal system done to confirm patency of lacrimal passages. Success of the procedure was documented as absence of epiphora and patent nasolacrimal duct on syringing. Results: Seventy three patients (males 27; females 46) were included in this study. Mean age of these patients was 51.6±21 years. On completion of this study which was three months after surgery, we found subjective improvement (absence of epiphora) in 86.3% patients and objective improvement (successful irrigation of lacrimal passages) in 93.2% patients. Conclusion: TC- DCR is a minimally invasive technique of doing Dacryocystorhinostomy and imparts more than 90% success rate. It has additional advantages of good cosmetic results, low complication rate and short surgery and convalescence time. doi: https://doi.org/10.12669/pjms.36.4.1906 How to cite this:Awais M, Naqvi SAH, Akram A, Shahid M. Transcanalicular diode laser assisted dacryocystorhinostomy: A breakthrough in the treatment of acquired nasolacrimal duct obstruction. Pak J Med Sci. 2020;36(4):---------. doi: https://doi.org/10.12669/pjms.36.4.1906 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Endoscopic DCR with and without prolene stent in rural area: a prospective randomized study

International Journal of Otorhinolaryngology and Head and Neck Surgery ◽

10.18203/issn.2454-5929.ijohns20182718 ◽

2018 ◽

Vol 4 (4) ◽

pp. 1081

Author(s):

Abhay Kumar ◽

Prateek Kumar Porwal ◽

Kailash Prasad Dubey ◽

Harshita Singh

Keyword(s):

Randomized Study ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Successful Outcome ◽

Endoscopic Endonasal ◽

Female Ratio ◽

Duct Obstruction ◽

Chronic Dacryocystitis ◽

Endonasal Dcr ◽

Endoscopic Dcr

Background: The objective of the study was to compare the results of endoscopic DCR with and without prolene stenting and to assess subjective and anatomical success in patients undergoing prolene stenting.Methods: The surgical outcomes of endoscopic endonasal DCR was compared in 100 patients of chronic dacryocystitis with nasolacrimal duct obstruction from June 2013 to May 2018. The successful outcome of surgery was defined by subjective improvement of symptoms and anatomical patency of the neo-ostium on syringing by nasal endoscopy. Results: In our study females were predominant in both groups with around 60% being females in group with stenting and 64% in group without stenting. Male to female ratio was 1:1.5 and 1:1.77 in group with stenting and without stenting. The symptomatic success rate of the surgery at the end of 3 months was 92% in group without stenting and 88% in group with stenting. There was no statistical difference in the results of two groups.Conclusions: We recommend that stenting is not routinely required for endoscopic DCR surgeries. A selective stenting approach may be advocated using prolene 3-0, using stenting for specific indications. With proper surgical technique and good follow up, endoscopic DCR without stenting is treatment of choice for chronic nasolacrimal duct obstruction.

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Dacryostenosis in Newborns: Probing, or Syringing, or Both?

European Journal of Ophthalmology ◽

10.1177/112067210001000206 ◽

2000 ◽

Vol 10 (2) ◽

pp. 128-131 ◽

Cited By ~ 7

Author(s):

A.A. Tahat

Keyword(s):

Methylene Blue ◽

High Pressure ◽

Nasolacrimal Duct ◽

Nasolacrimal Duct Obstruction ◽

Congenital Nasolacrimal Duct Obstruction ◽

Duct Obstruction ◽

The Third ◽

Lacrimal System ◽

Age Range ◽

Nasolacrimal Ducts

Purpose This prospective study was designed to establish whether it is more effective to treat symptomatic congenital nasolacrimal duct obstruction by probing, or high-pressure irrigation, or both. Methods During the period February 1991 to January 1999, 228 infants (300 nasolacrimal ducts) were examined (132 males, 96 females, age range 12–13 months). These patients were divided into three groups of 100 ducts each. The first group was probed only; in the second group the nasolacrimal ducts were irrigated under high pressure using methylene blue-stained saline, and the third group was probed and irrigated in the same setting. The procedures were done under light general anesthesia. Results Ninety-one ducts in the first group improved after probing. In the second group 64 ducts improved after irrigation. In the third group 96 ducts improved after both probing and irrigation. Conclusions To treat symptomatic congenital nasolacrimal duct obstruction, it is more effective to combine high-pressure irrigation and probing. This gives a better success rate, first in treatment and secondarily, permitting intraoperative verification of the patency of the excretory lacrimal system.

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External dacryocystorhinostomy

Asian Journal of Ophthalmology ◽

10.35119/asjoo.v16i3.510 ◽

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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