Endoscopic dacryocystorhinostomy with an otologic T-type ventilation tube in repeated revision cases

Abstract

BackgroundTo compare the frequency of appearance of complications, anatomical success and functional success after conventional endoscopic dacryocystorhinostomies (EN-DCRs) or EN-DCR with otologic T-Type ventilation tube combined with silicone tube intubation in repeated revision cases.MethodsTwenty-two patients who had epiphora and recurrent dacryocystitis after at least a previous failed revision DCR as well as 22 patients receiving conventional EN-DCR only were enrolled in the study between January 2008 and December 2011. Operations were performed by using an otologic T-tube combined with silicone tube intubation. Oral antibiotics, nasal steroids, oral antihistamines, and antibiotic eyedrops were given to all cases. The ventilation tubes were removed 6 to 20 weeks after surgery.ResultsOf 22 cases, all cases achieved anatomical success, 19 cases were symptom free, and 3 cases had decreased continuation in complications with a functional success rate of 81.8%. The overall success rates were significantly higher than those in patients undertaking conventional EN-DCR only (P < 0.01).ConclusionThe revision endoscopic DCR has a high rate of failure. The usage of a T-type ventilation tube can significantly improve the success rate of surgery.Trial registration numberChiCTR-INR-17012160, retrospectively registered on July 27th, 2017.

Modified external revision-DCR in previous failed endonasal, transcanalicular or external-DCR: technical strategy and teaching Pearls for success

“…All our modified revised or primary modified Ex-DCR cases had both anterior and posterior sacco-mucosal flaps that may have contributed to the high success rates. Although some alternative approaches have been suggested for the treatment of failed cases, such as nasolacrimal recanalization (84.4%) [ 14 ], traditional approaches regarding the success rates of rDCRs revealed that rEE-DCR with silicone tube intubation has been reported to have a success rate of about 82.0% [ 15 ]. In the present Ex-DCR revision, none of the cases, except for 6 patients with atrophic sacs, required stent implantation, and the success rate was higher with the aid of sufficient bony opening in a proper location and anterior sacco-mucosal suspension.…”

Endoscopic DCR: A 10 Years Personal Experience

“…A study by Demarco et al [33], concluded that revision endoscopic DCR after failed external surgery is a safe technique of low morbidity, permitting effective resolution of the lacrimal obstructions. As the revision endoscopic DCR has a high rate of failure, the usage of a T-type ventilation tube can significantly improve the success rate of surgery [34].…”

Intraoperative prevention of dacryocystitis relapse

“…В настоящее время многие авторы применяют для профилактики рецидива после операции биканаликулярную интубацию дакриостомы [24][25][26].…”