Efficacy of endonasal dacryocystorhinostomy, using ‘cold steel’ instruments without stenting, in treatment of distal nasolacrimal duct obstruction

Ananth, Lakshmi; Hosamani, Pradeep; Chary, Geetha

doi:10.1017/s002221511100017x

Cited by 10 publications

(5 citation statements)

References 24 publications

(45 reference statements)

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“…6 Endoscopic DCR avoids division of the medial canthal ligament, which carries less risk of interfering with the physiologic lacrimal pump mechanism. 3,5,10 Previous meta-analyses showed that endoscopic DCR is associated with lower bleeding, infection, and revision rates, albeit not statistically significantly. 6…”

Section: Discussionmentioning

confidence: 99%

“…This was characterized by a patent rhinostomy on endoscopic examination, patent lacrimal system on irrigation, or passage of fluorescein dye as confirmed endoscopically in the nasal cavity on postoperative endoscopy. 5,16–19 The second method was by evaluating the patient's perception of benefit or symptom resolution after the procedure, 16 which can range from simply asking the patient if his or her epiphora resolved after the operation 5 or by using a questionnaire in an attempt to objectively quantify the degree of symptomatic improvement and residual burden of symptoms if present. 3,10,12,15…”

Section: Discussionmentioning

confidence: 99%

“…Studies from the last decade showed that endoscopic endonasal DCR compares favorably with external DCR in both the primary and revision setting. 1,3–7…”

mentioning

confidence: 99%

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Comparison between Endoscopic and External Dacryocystorhinostomy by Using the Lacrimal Symptom Questionnaire: A Pilot Study

Wong

Dean²,

Nair

2018

Am J Rhinol�Allergy

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Our study indicated that both endonasal and external DCR can lead to improvement in quality of life by using a validated questionnaire. Although there are differences in age and anatomic success rates between the two groups, subgroup analyses indicated that the differences in the Lac-Q scores persisted when age and anatomic patency were removed as potential confounding factors. Further larger, randomized studies would be helpful.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Comparison between Endoscopic and External Dacryocystorhinostomy by Using the Lacrimal Symptom Questionnaire: A Pilot Study

Wong

Dean²,

Nair

2018

Am J Rhinol�Allergy

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“…Ananth и соавт. [40] не интубировали дакриостому лакримальным имплантатом в рутинных случаях выполнения эндоскопической эндоназальной ДЦР, указывая на то, что это целесообразно только при сужении устья слезных канальцев. Так, C. Callejas и соавт.…”

Section: применение лакримальных имплантатовunclassified

Intraoperative prevention of dacryocystitis relapse

et al. 2018

Vestn. oftal'mol.

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Впервые концепция эндоназальной хирургии слезоотводящих путей была предложена G. Caldwell в 1893 г. [1]. J. West в 1910 г. разработал технику эндоназальной дакриоцисториностомии (ДЦР), создав костное окно в слезной и верхнечелюстной костях, что позволило визуализировать слезный мешок и носослезный проток со стороны полости носа [2]. D. Rice в 1988 г. отработал концепцию эндоскопической эндоназальной ДЦР на кадаверных препаратах и предложил использовать этот метод в качестве альтернативы наружной ДЦР [3]. M. McDonogh и J. Meiring в 1989 г. начали первыми применять эндоскопическую эндоназальную ДЦР в клинике [4]. Базовую технику эндоскопической эндоназальной ДЦР, которую используют (с некоторыми модификациями) по настоящее время, предложил в 2002 г. P. Wormald [5]. С тех пор многими авторами были внесены различные предложения по изменению и дополнению техники операции, направленные на

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“…A number of authors consider intubation of TD as one of the important and obligatory components of effective treatment and prevention of recurrences of CD [6,7]. The opposite opinion is based on the lack of difference in the effectiveness of treatment of this disease [8][9][10]. In addition, during the stay of the implant in the lumen of the TD there is a high level of complications, despite the use of bioinert materials such as silicone, propylene, polyurethane, etc.…”

Section: Introductionmentioning

confidence: 99%

Method of surgical treatment of chronic dacryocystitis and its effectiveness in monitoring patients in the early postoperative period

Zabolotnyi

Minaiev

2021

SR:MS

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The aim. To develop a method for endonasal endoscopic dacryocystorhinostomy (EEDCR) and evaluate its effectiveness in monitoring patients in the early postoperative period. Materials and methods. The study group (1st group) consisted of 45 patients with chronic dacryocystitis (CD), who underwent EEDCR according to the developed method, the comparison group (2nd group) included 36 patients who, after performing the developed EEDCR, an implant was installed in the dacryorhinostoma zone. The control group (3rd group) included 28 patients who underwent EEDCR according to the generally accepted method. Patients of groups 1 and 2 were divided into 2 subgroups: 1A and 2A included patients who underwent computed tomography of the lacrimal ducts in the preoperative period according to the developed method, and patients of subgroups 1B and 2B – according to the traditional algorithm. Reliably the best results of restoring lacrimation function were in subgroups 1A and 1B already from the 3rd day of observation after surgery, as well as in the subsequent periods of observation. The worst values of lacrimation function were recorded in the control clinical group with a statistically significant difference from other groups (p<0.05). When comparing the results of treatment of subgroups 1A with 1B and 2A with 2B, the best indicators were observed in subgroups 1A and 2A, but due to the small sample of patients, statistical significance in the differences could not be achieved (p>0.05). Results. A method of EEDCR has been developed, a comparative analysis of groups of patients according to the above indicators has been performed when observing patients in the early postoperative period. On the first day after surgery, the mean score of the severity of lacrimation according to the Munk scale significantly decreased in all groups and gradually decreased on the 7th day and after 2 weeks (p<0.05). Significantly better indicators were in subgroups 1A and 1B in the entire early postoperative period (p<0.05). The degree of edema of the mucosa of the dacryorhinostoma zone and the middle nasal meatus at all periods of observation was the lowest in subgroup 1A from 3rd day and in each subsequent period of observation with a statistically significant difference from other groups (p<0.05). On the 7th day, significantly more patients with mucous discharge in the area of dacryorhinostoma and middle nasal meatus were observed in subgroup 2B and in 3rd group (p<0.05), and significantly better results were noted in subgroup 1A, where more than 2/3 patients had no mucous discharge. Reliably the best results of restoring lacrimation function were in subgroups 1A and 1B already from the 3rd day of observation after surgery, as well as in the subsequent periods of observation. The worst values of lacrimation function were recorded in the control clinical group with a statistically significant difference from other groups (p<0.05). When comparing the results of treatment of subgroups 1A with 1B and 2A with 2B, the best indicators were observed in subgroups 1A and 2A, but due to the small sample of patients, statistical significance in the differences could not be achieved (p>0.05). Conclusions. The developed EEDCR method complies with the principles of sparing surgery, is effective in the treatment of patients with CD, while there is a faster rate of recovery of the lacrimal function and mucosa, improves the quality of life of patients

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Efficacy of endonasal dacryocystorhinostomy, using ‘cold steel’ instruments without stenting, in treatment of distal nasolacrimal duct obstruction

Abstract: Meticulous surgical technique can ensure high success rates with the use of conventional cold steel instruments, without the use of adjunctive procedures, making endonasal dacryocystorhinostomy a cost-effective, reliable procedure.

Cited by 10 publications

References 24 publications

Comparison between Endoscopic and External Dacryocystorhinostomy by Using the Lacrimal Symptom Questionnaire: A Pilot Study

Comparison between Endoscopic and External Dacryocystorhinostomy by Using the Lacrimal Symptom Questionnaire: A Pilot Study

Intraoperative prevention of dacryocystitis relapse

Method of surgical treatment of chronic dacryocystitis and its effectiveness in monitoring patients in the early postoperative period

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