Ballooning canaliculoplasty after lacrimal trephination in monocanalicular and common canalicular obstruction

Yang, Suk-Woo; Park, Hae Young; Kikkawa, Don O.

doi:10.1007/s10384-008-0598-7

Cited by 24 publications

(14 citation statements)

References 25 publications

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“…Compared with the single-stent group, no significant complications appeared, which was consistent with previous reports [11][12][13][14][15]. The other treatment methods implicated for canalicular obstruction are DCR combined with membranectomy [5,6], trephination and silicone tube stenting [7,16], ballooning with/without silicone stenting [17,18], ballooning canaliculoplasty following lacrimal trephination [8], and intraoperative use of mitomycin C [9,10]. The success rates of these procedures vary in the range of 25-92% with the majority being under 50-60% (Table 7).…”

Section: Discussionsupporting

confidence: 86%

“…For canalicular obstruction, the cause of failure is restenosis or sticky adhesive changes of the canaliculus following the removal of the silicone tube [5][6][7][8][9][10]. We reasoned that the insertion of a wider stent would make the canalicular pathway more patent and aid in maintaining the clearance of the pathway following removal of the tube.…”

Section: Introductionmentioning

confidence: 95%

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Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Paik

Cho

Yang

2011

Eur Arch Otorhinolaryngol

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The purpose of the study was to evaluate the clinical effects of bicanalicular double silicone stents in endoscopic transnasal dacryocystorhinostomy with lacrimal trephinized canaliculoplasty for monocanalicular and common canalicular obstruction. Bicanalicular double silicone intubation in endoscopic transnasal dacryocystorhinostomy with lacrimal trephination was performed in 58 eyes of 54 patients (5 men, 49 women; mean age: 55.9 ± 14.9 years) with epiphora due to monocanalicular and common canalicular obstruction between November 2007 and August 2010. We reviewed the records of subjects who had undergone the same surgery with a bicanalicular single intubation for same disease between March 2004 and October 2007 as controls (56 eyes of 50 patients). We evaluated age, gender, the operative side, the site of canalicular obstruction, and the effects of double silicone intubation. Complications relating to the silicone tube were also investigated. The double-stent group showed higher anatomical success rates (91.4%) and functional success rates (82.8%) than the single-stent group (75.0 and 69.6%, respectively) (p = 0.034 and p = 0.103, respectively). Bicanalicular double silicone stenting in endoscopic transnasal dacryocystorhinostomy with lacrimal trephinized canaliculoplasty may be an effective treatment for monocanalicular and common canalicular obstructions. This may also reduce more invasive surgery including Jones tube insertion (p = 0.038).

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Section: Discussionsupporting

confidence: 86%

Section: Introductionmentioning

confidence: 95%

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Paik

Cho

Yang

2011

Eur Arch Otorhinolaryngol

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“…5 Yang employed trephination followed by balloon canaliculoplasty in patients with distal monocanalicular and CCO with success rates of 54%. 8 Trephination and intubation during EnDCR surgery has not been widely reported. In a small series of five patients, Nemet reported symptomfree results in four out of five patients following EnDCR with trephination and application of mitomycin C (MMC) in distal and CCO where the obstruction was at least 7 mm from the punctum.…”

Section: Discussionmentioning

confidence: 99%

“…Some techniques can be performed in an office setting, while others are used as an adjunct to more invasive lacrimal surgery. [2][3][4][5][6][7][8] In the setting of transnasal endoscopic dacryocystorhinostomy (EnDCR), one previous study has reported retrospective outcomes of trephination for CCOs. 9 To our knowledge, this is the first study that has employed membranectomy without trephination and has attempted to evaluate the outcome of both membranous and more solid distal obstructions of the common canaliculus.…”

Section: Introductionmentioning

confidence: 99%

A prospective outcome study of membranous and solid distal common canalicular obstructions

Shams

Pirbhai

Selva

2016

Eye

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Purpose To prospectively evaluate the surgical outcomes of membranous and solid distal common canalicular obstructions (CCOs) following endoscopic dacryocystorhinostomy (EnDCR) and lacrimal intubation combined with either membranotomy or trephination. Methods This was a prospective, nonrandomized, consecutive interventional case series. Inclusion criteria included patients undergoing EnDCR with evidence of a membranous block or more solid obstruction of the distal common canaliculus, treated with membranotomy or canalicular trephination. Complete CCO was confirmed pre-operatively using dacryocystography and dacryoscintigraphy. All patients received bicanalicular intubation for 3 months with a minimum follow-up of 12 months. Functional and anatomical success was assessed at 4 weeks, 3 months, and 12 months following surgery. Functional success was defined as subjective improvement of epiphora and anatomical success as the presence of a patent ostium and a positive dye test on nasal endoscopy. Results Twenty-nine patients were included in the study with a mean age of 58 years. Twentyone patients (72%) received a membranotomy and eight (28%) required trephination. At 12 months, the functional and anatomical success rate in the membranotomy group was 90% (19/21) and 100% (21/21), respectively, and in trephination group the functional and anatomical success rate was 63% (5/8). There were no intraoperative or lacrimal stent-related complications. Conclusions Identifying and excising distal CCOs in association with EnDCR and lacrimal intubation is associated with a high degree of functional (83%) and anatomical (90%) success. The success of membranous obstructions appear be superior to outcomes for solid obstructions of the distal common canaliculus that require trephination.

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“…Recently, it has been reported that silicone intubation following ballooning dilation after lacrimal trephination is a simple and well tolerated method that may be a good alternative treatment for common canalicular and distal canalicular obstructions, before resorting to conjunctivodacryocystorhinostomy (CDCR) with Jones tube insertion [20 ]. Immediate clinical improvement can be achieved in 82% of cases and common canalicular obstructions have better prognosis than monocanalicular obstructions [20 ].…”

Section: Balloon Canaliculoplastymentioning

confidence: 98%

Management of canalicular obstructions

Liarakos

Boboridis²,

Mavrikakis

et al. 2009

Current Opinion in Ophthalmology

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Ballooning canaliculoplasty after lacrimal trephination in monocanalicular and common canalicular obstruction

Abstract: Balloon canaliculoplasty after lacrimal trephination is a simple and safe method that may be a good alternative treatment for common canalicular and distal canalicular obstructions, before resorting to conjunctivodacryorhinostomy with Jones tube insertion.

Cited by 24 publications

References 25 publications

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

A prospective outcome study of membranous and solid distal common canalicular obstructions

Management of canalicular obstructions

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