The objective is to compare the success rates of revision endonasal dacryocystorhinostomy (END-DCR) with revision external dacryocystorhinostomy (EXT-DCR). The present retrospective study was conducted between January 2002 and July 2009. Seventy-four consecutive patients (17 males, 57 females) who had epiphora or recurrent dacryocystitis after a previous failed EXT-DCR procedure were enrolled in the study. The END-DCR group consisted of 43 patients (10 males, 33 females) who underwent 44 END-DCRs, whereas the EXT-DCR group included 31 patients (7 males, 24 females) who underwent 31 dacryocystorhinostomies (DCRs). Successful DCR was defined as relief of symptoms as demonstrated by saline irrigation at the last post-operative visit. Further nasal surgery was performed in 18 (40.9%) eyes in the END-DCR group. The average follow-up time for the END-DCR and EXT-DCR groups was 11 and 9 months, respectively. The success rate was 77.4% (24/31 DCRs) in the END-DCR group, and 84.1% (37/44 DCRs) in the EXT-DCR group. There was no significant difference between the groups regarding overall success (p = 0.465). END-DCR is as safe and efficient technique as external approach with low complication rates in revision cases. END-DCR yields good esthetic and functional results and has a success rate similar to that of the external approach.
This is a study evaluating the efficacy of Ankaferd Blood Stopper (ABS) as a hemostatic agent compared to hemostasis by phenylephrine in patients with anterior epistaxis. The study design is a prospective, randomized, controlled, nonblinded, clinical trial. In total, 49 patients were randomly seperated to receive hemostasis technique by means of either ABS wet tampon or phenylephrine impregnated gauze tampon for anterior epistaxis control. Patients were crossed over to the other technique after two unsuccessful attempts of the first technique. Measured outcomes such as number of applications, relationship of number of applications with bleeding intensity (1 = stains on napkin, 2 = soaked napkin, 3 = bowl needed), patient discomfort during hemostasis (0 = none, 9 = unbearable), and complications were assessed. Additional data were recorded for rebleeding within 7 days. 24 of the 49 patients were assigned to the new ABS group (group I) and remaining 25 were included in the standard phenylephrine group (group II). ABS was more effective than phenylephrine at control of anterior epistaxis (79.2 vs. 64%, p < 0.05). For the patients who crossed over from phenylephrine to ABS, 44.4% achieved hemostasis by ABS. ABS successfully treated all bleeding intensity 1 and 2 patients with one application (5 min). ABS patients experienced fewer rebleeding rates within 7 days compared to phenylephrine patients (8.3 vs. 20%, p < 0.05). The patients for which ABS was applied, significant differences in effective control of anterior epistaxis were observed compared to phenylephrine. ABS is effective, safe, quick, and easy alternative to the phenylephrine in patients with anterior epistaxis.
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