Dilatation and stenting for naso‐lacrimal duct obstruction, A pilot project

Abstract

ABSTRACT.Purpose: Obstruction of the naso-lacrimal duct has traditionally been treated by dacryocystorhinostomy. This pilot project aimed to evaluate the use of stents as an alternative approach to the treatment of naso-lacrimal duct obstruction. Methods: Six patients with naso-lacrimal duct obstruction underwent a preprocedural dacryocystogram to confirm the site of obstruction. Under local anaesthesia, they subsequently underwent dilatation of the naso-lacrimal duct using a guide wire and a plastic dilator aided by fluoroscopy and digital subtraction imaging. The stent was then placed with its head in the lacrimal sac and tail protruding out of the naso-lacrimal duct into the inferior meatus. Dacryocystography was repeated to confirm patency. Patients were followed up for a minimum of 12 months. Results: The procedure was successfully completed in four of the six patients. In one patient, we failed to negotiate the guide wire and in one, a false passage was created. All four successful cases were rendered asymptomatic and their lacrimal passages remained patent at 12 months. Conclusion: Naso-lacrimal duct dilatation and stenting is a viable alternative to conventional dacryocystorhinostomy in the treatment of naso-lacrimal duct obstruction and merits a larger trial.

External dacryocystorhinostomy for the treatment of acquired partial nasolacrimal obstruction in adults

“…Other authors have reported success with polyurethane stents but long term results are lacking. 14 15 Angrist et al 16 found silicone intubation for partial obstruction yielded good results in 73.9% of patients but this does not appear to reflect the experience of others. 7 17 Overall, our surgical success is considerably higher, achieving 84% subjective success at 3.6 months and 70% at 3 years.…”

Avaliação da epífora de cães usando dacriocistografia e tomografia computadorizada

“…O exame radiográfico contrastado realizado prestou-se como método de reconhecimento da anatomia e da localização das estruturas do sistema de drenagem lacrimal dos cães, proporcionando, também, a verificação da patência dessas estruturas, conforme também relatado por vários autores na Medicina e na Veterinária, como Caye et al (1986), Slatter (1990a), Habin (1993), Barnett et al (1995), Takano & Mendonça Júnior (1996), Carneiro Filho (1997, Pereira et al (1997), Shankar et al (1999), Stades et al (1999), Wearne et al (1999), Grahn (2002), Gelatt (2003, Winston & Prasse (2003), Kleiner et al (2004), Nykamp et al (2004) e Silva (2004), que apontam a dacriocistografia como importante exame auxiliar. No presente trabalho, foi possível avaliar anatomicamente o sistema lacrimonasal também pela dacriocistografia por tomografia computadorizada contrastada, o que auxiliou na avaliação do sistema lacrimonasal em pacientes com alterações nas vias lacrimais concordando com os autores Costa et al (1997) que afirmaram que a semiologia da via lacrimal excretora envolve dados da anamnese, avaliação anatômica e funcional.…”