A Modified Technique of External Dacryocystorhinostomy

Picó, Guillermo

doi:10.1016/0002-9394(71)90001-8

Cited by 65 publications

(35 citation statements)

References 13 publications

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“…Success rate of external DCR has been reported between 80-99% and average failure rate as reported in literature is 9.4%. [3][4][5][6][7][8]15,17,24 Failure is generally defined as having symptoms of excessive tearing with the inability to irrigate. Mc Pherson and Egelston noted that three out of seven patients in their study who underwent a second operation were found to have dense scar tissue present at the osteotomy site.…”

Section: Discussionmentioning

confidence: 99%

“…Success rate of external DCR has been reported between 80-99%, depending on surgeon's experience. [3][4][5][6][7] Failure is attributed to many factors -common canalicular obstruction, scarring within anastomosis, closure of osteotomy site by membrane, adhesion or synechia formation between ostium and middle turbinate or a deviated nasal septum and malpositioned ostia. [8][9][10] Two most frequent causes of DCR failure are common canalicular obstruction and closure of osteotomy site.…”

Section: Introductionmentioning

confidence: 99%

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A comparative study on intraoperative mitomycin-c augmented external dacryocystorhinostomy with conventional dacryocystorhinostomy

Puzari

Kumar

2016

Int J Res Med Sci

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Background: Dacryocystorhinostomy (DCR) is a commonly done surgery performed for management of epiphora due to nasolacrimal duct obstruction. Goal of the procedure is to bypass the obstructed nasolacrimal duct allowing tear drainage into the nasal cavity directly from lacrimal sac by creating an anastomosis between the lacrimal sac and the nasal mucosa via a bony ostium. Common cause of DCR failure are attributed as an end effect of fibrous tissue growth, scarring and granulation tissue formation which obstructs the new drainage channel. Mitomycin c is an antiproliferative agent and may enhance the result of DCR by inhibiting fibrous tissue proliferation. Here we aim to evaluate the results of intraoperative mitomycin C application in dacryocystorhinostomy surgery compared with the result of conventional DCR. Methods: A prospective randomized comparative study of one year duration was done in the Department of Ophthalmology, Assam Medical College and Hospital, Dibrugarh, Assam, India. A total of 60 patients of acquired nasolacrimal duct obstruction were enrolled and divided randomly into two groups, 30 nos of patients in each group. One group had undergone conventional external DCR operation and other group was treated with DCR surgery with intraoperative mitomycin C application at the anastomotic flap and osteotomy site. Patients were reviewed after 1week, 1month, 3month and 6months postoperatively. The results of DCR surgeries were evaluated by observation of different parameters such as height of tear meniscus and patency of the nasolacrimal passage. Results: In our study we have observed that majority of cases were in 21-30 years age group with female preponderance (male vs female; 35% vs 75%). Chronic dacryocystitis was seen in majority of cases (70%) followed by mucocele (26.67%) and lacrimal fistula (3.33%). Major difficulties encountered during surgery and postoperatively were almost identical in both the groups. There was no case of abnormal mucosal bleeding, mucosal necrosis, delayed wound healing in patients which underwent DCR with mitomycin C use. Post-operative care and follow up were done identically in both the groups. It was seen that a total success rate of 80% was achieved in conventional group where as 96.67% success was achieved in MMC group at the end of 6 months. In case of scar prone conditions like lacrimal fistula mitomycin C use has shown to be efficacious in maintaining patency of the system after surgery. Conclusions: Distinctly higher success rate have been achieved in patients undergoing DCR with intra-operative MMC as compared to patients undergoing conventional DCR. Use of intraoperative mitomycin C can be considered safe and simple but very effective modification of conventional external DCR.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A comparative study on intraoperative mitomycin-c augmented external dacryocystorhinostomy with conventional dacryocystorhinostomy

Puzari

Kumar

2016

Int J Res Med Sci

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“…Causes of failed DCR include fibrous tissue growth, inappropriate size or location of bony ostium, scarring within the osteotomy, common canalicular obstruction, sump syndrome, intervening ethmoid sinus air cells, interference of the middle turbinate, collapse of the bridge between anterior flaps and previously identified canalicular stenosis, active systemic disease, nasal polyposis and concha bullosa [15][16][17][18][19][20].…”

Section: Discussionmentioning

confidence: 99%

Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

Rizvi

Sharma

Tripathy

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The aim of this work is to study the management and success rate of traumatic dacryocystitis and failed dacryocystorhinostomy (DCR) using Silicone lacrimal intubation set. A prospective study was conducted at a tertiary eye care hospital, India from February 2006 to January 2008. This study material comprised 50 patients of traumatic dacryocystitis and failed dacryocystorhinostomy. Anterior single flap external dacryocystorhinostomy with Silicon intubation was performed in all the patients. The patients were followed up at weekly intervals for 1 month and thereafter every 2 months for 1 year post operatively. Criteria determining success were based on resolution of epiphora and patency on syringing. In traumatic dacryocystitis, 21(91.3%) cases fulfilled these criteria while 23(85.2%) cases of failed DCR were successful. The overall success rate (88%) was determined with an average follow-up of 1 year. Globally, the technique was effective in 85% of cases. The results were comparable with other similar studies. This study concludes that performing a DCR in traumatic dacryocystitis and failed DCR taking into consideration the complications and chances of failure is a challenge for the surgeon. We opine that External dacryocystorhinostomy with Silicon Intubation is one of the most effective modality in dealing with such cases.

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“…[10] Pico stated that "In every instance, the cause of failure was found at the secondary surgery to be an obstruction of the new drainage channel by an occluding membrane, which on histologic examination was shown to be composed of organised granulation tissue." [11] Kao et al [6] , Liao et al [12] evaluated the role of intraoperative Mitomycin-C in external DCR. Liao et al [12] and You and Fang [13] concluded that intraoperative Mitomycin-C application was effective in increasing the success rate of external DCR surgery, whereas Roozitalb et al [14] concluded that Mitomycin-C does not change the success rate of this procedure.…”

Section: Discussionmentioning

confidence: 99%

Endoscopic Dacryocystorhinostomy With and Without Intraoperative Mitomycin-C: A Comparative Study

Gupta¹,

Purohit²,

Bhan³

et al. 2016

jemds

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AIMS AND OBJECTIVEThe objective of this study is to compare the results of endonasal endoscopic dacryocystorhinostomy with and without local Mitomycin-C application in patients of primary nasolacrimal duct obstruction. DESIGNProspective Randomized Case Control Study. MATERIALS AND METHODSStudy included 80 patients (88 eyes) between January 2013 and January 2016, assigned randomly in 2 groups. Group A included 30 patients (46 eyes) in Mitomycin-C group and group B included 30 patients (42 eyes) in non-Mitomycin-C group. Surgical procedures in both groups were same. Followup period regarding condition of tearing improvement was done at 1 week, 3 weeks and at 6 months postoperatively. RESULTSSuccess rate with Mitomycin-C was 90% and without Mitomycin-C were 85%. The outcome of two groups was found statistically insignificant. Complications noted were granulations, synechiae, periorbital oedema and punctual trauma with no significant difference in frequency of occurrence as well postop results in two groups. CONCLUSIONIntraoperative use of 0.2 mg/mL at rhinostomy site does not affect the success rates of endoscopic DCR, both functionally and anatomically. KEYWORDSNasolacrimal Duct Obstruction (NLD), Mitomycin-C, Endoscopic DCR. HOW TO CITE THIS ARTICLE:Gupta R, Purohit JP, Bhan C, et al. Endoscopic dacryocystorhinostomy with and without intraoperative mitomycin-c: a comparative study.

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A Modified Technique of External Dacryocystorhinostomy

Cited by 65 publications

References 13 publications

A comparative study on intraoperative mitomycin-c augmented external dacryocystorhinostomy with conventional dacryocystorhinostomy

A comparative study on intraoperative mitomycin-c augmented external dacryocystorhinostomy with conventional dacryocystorhinostomy

Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

Endoscopic Dacryocystorhinostomy With and Without Intraoperative Mitomycin-C: A Comparative Study

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