Reliable technique of Endoscopic Dacryocystorhinostomy – A Pilot Study
Article Sidebar
Main Article Content
Abstract
Introduction
Over last two decades endoscopic dacryocystorhinostomy has gained popularity over external dacryocystorhinostomy for post-canalicular obstruction. But the success rate is not very satisfactory. Our objective is to describe a technique where near 100% success can be achieved.
Materials and Methods
The study was conducted on 92 patients over 4 years and 6 months. The technique we describe involves creation of a large ostium, creation and apposition of nasal and lacrimal sac mucosal flaps. All the patients were under regular follow-up for12 months after operation. We also compared our result with other techniques.
Results
The neo-ostium was well healed and free flow of normal saline was seen in 90 cases (97.83%) post-operatively. In one case there was ostium fibrosis and in another case granulations were seen.
Conclusion
For the past few decades many approaches have been tried for endoscopic dacryocystorhinostomy. But the long term success rates have not been satisfactory. Our technique of creating large stoma and proper mucosal apposition, when done properly gives near 100% success.
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
References
Toti A. Nuovo método conservatore di cura radicale délie suppurazioni eroniei del sacco lacrimale (daeriocistorinostomia). Clin Med Firenze 1904; 10:38.5-7
Caldwell GW. Two new operations for obstruction of the nasal duct. N Y J Med l893; 57:581-2
Ishio K, Sugasawa M, Tayama N, Kaga K. Clinical usefulness of endoscopic intranasal dacryocystorhinostomy. Acta Otolaryngol Suppl. 2007; 559:95-102
McDonough M, Meiring JH. Endoscopic transnasaldacryocystorhinostomy. J Laryngol Otol. 1989; 103:585-7
Zaidi FH, Symanski S, Olver JM. A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction 2011; 25:1219-24
Leong SC, Macewen CJ, White PS. A systematic review of outcomes after dacryocystorhinostomy in adults. Am J Rhinol Allergy 2010; 24:81-90
Smimov G, Tuomilehto H, Teräsvirta M, Nuutinen J, Seppä J. Silicone tubing after endoscopie dacryocystorhinostomy: is it necessary? Am J Rhinol. 2006; 20:600-2
Hartikainen J, Grenman R, Puukka P, Seppa H. Prospective randomized comparison of external dacryocystorhinostomy and endonasal laser dacryocystorhinostomy. Ophthalmology 1998; 105:1106-13
Woo KI, Maeng HS, Kim YD. Characteristics of intranasal structures for endonasal dacryocystorhinostomy in asians. Am J Ophthalmol. 2011; 152(3):491-8 doi: 10.1016/j.ajo.2011.02.019
Kakkar V, Chugh J, Sachdeva S, Sharma N, Ramesh. Endoscopic Dacryocystorhinostomy with and without Silicone Stent: A Comparative Study. The Internet Journal of Otorhinolaryngology. 2008 Volume 9 Number 1
Mudhol RR, Zingade ND, Mudhol RS, Das A. (2012) Endoscopic Ostium Assessment Following Endonasal Dacryocystorhinostomy with Mitomycin C Application. Al Ameen J Med Sci. 2012; 5:320-4
Naik SM, Mushannavar AS et al. Endonasal dacrocystorhinostomy done with and without silicon stents—A comparative case series analysis study. Int J Head Neck Surg. 2012; 3(3): 147-53
Jain NK, Vashistha S, Kaushik S. Comparative Study of Endonasal Endoscopic Dacryorhinostomy with or without Intraoperative Mitomycin C. Clin Rhinol An Int J. 2013; 6(2):77-9
Shah H, Sharma S et al. Comparison of surgical outcome in endoscopic dacrocystorhinostomy with and without silicon stent placement. Nat J Med Res. 2013; 3(1):34-7
Sharma BR. Non endoscopic endonasal dacryocystorhinostomy versus external dacryocystorhinostomy. Kathmandu Univ Med J. 2008; 6:437-42
Zuercher B, Tritten JJ, Friedrich JP, Monnier P. Analysis of functional and anatomic success following endonasal dacryocystorhinostomy. Ann Otol Rhinol Laryngol. 2011;120:231-8
Zilelioglu G, Ugurbas SH, Anadolu Y et al. Adjunctive use of mitomycin C on endoscopic lacrimal surgery. Br J Ophthalmol. 1998; 82: 63-66
Ghosh S, Roychoudhury A, Roychaudhuri BK (2006) Use of mitomycin C in endo-DCR. Indian J Otolaryngol Head Neck Surg. 58: 368-9
Farooq MU, Ansari MA, Khyani IA. Role of mitomycin C in endoscopic management of nasolacrimal duct obstruction. J Dow Uni Health Sci. 2013; 7(2): 63-7
Ji Qing-Shan et al. New Mucosal Flap Modification for Endonasal Endoscopic Dacryocystorhinostomy in Asians. International Journal of Ophthalmology 2012; 5(6):704-7
Sonkhya N, Mishra P. Endoscopic transnasal dacryocystorhinostomy with nasal mucosal and posterior lacrimal sac flap. J Laryngol Otol. 2009; 123:320-6
Sprekelson MB. Endoscopic dacryocystorhinostomy- surgical techniques and results. Laryngoscope 1996; 106:187-9
Unlu HH, Toprak B, Aslan A, Guler C. Comparison of surgical outcomes in primary endoscopic dacryocystorhinostomy with and without silicone intubation. Ann Otol Rhinol Laryngol. 2002; 111:704-9
Smimov G, Tuomilehto H, Teräsvirta M, Nuutinen J, Seppä J. Silicone tubing after endoscopie dacryocystorhinostomy: is it necessary? Am J Rhinol. 2006; 20:600-2
Ray B, Datta D, Roy P. Long Term Success of Endo-DCR with Silicone Tube Catheter (STC) versus Endo-DCR without STC: A Comparative Study. Bengal J Otolaryngol Head Neck Surg. (BJOHNS) 2016; 24(2):88-93
Jin HR, Yeon JY, Choi MY. Endoscopic dacryocystorhinostomy: Creation of a large marsupialized lacrimal sac. J Korean Med Sci. 2006; 21:719-23
Zilelioglu G, Tekeli O, Ugurba SH, Akiner M, Akturk T, Anadolu Y. Results of endoscopic endonasal non-laser dacryocystorhinostomy Doc Ophthalmol. 2002; 105:57-62
Kim JH, Shin JH, Sony HY, et al. Long-term results and factors affecting patency after removal of nasolacrimal stents. J Vasc Interv Radiol. 2006; 17 (7): 1125-30
Farooq MU, Ansari MA. Cerebrspinal fluid rhinorrhea: etiology, site of leakage and endoscopic management. J Coll Physicians Surg Pak. 2011; 21:460-3
Roozitalab MH, Amirahmadi M, Namazi MR. Results of the application of intraoperative
Mitomycin C in dacryocystorhinostomy. Eur J Ophthalmology 2004; 14(6):461-3
Farahani F, Ramezani A. Effect of intra operative mitomycin C application on recurrence of endoscopic dacryocystorhinostomy. Saudi Med J. 2008; 29 (9): 1354-1356.