Endoscopic dacryocystorhinostomy with and without silicone intubation: 4 years retrospective study

Abstract

The objective of this study is to assess different outcomes between endoscopic dacryocystorhinostomy (En-DCR) with and without silicone intubation. We retrospectively analyzed 84 patients (89 procedures), suffering from chronic epiphora for primary acquired nasolacrimal duct obstruction, treated with En-DCR and divided into two groups depending on silicone stent intubation. The surgical outcomes were evaluated at 7 post-operative controls using Munk's score criteria. Functional success was defined as absence of epiphora, no further episodes of dacryocystitis, and a patent ostium after fluorescein irrigation. 45 En-DCR with stent and 44 En-DCR without stent were performed. Success rate after 18 months follow-up were, respectively, 82.2 % in the stent group and 88.6 % in the non-stent group (OR 0.59) with no statistical differences. The ostial size reduction has been reported in higher percentage in the stent group, mainly due to peristomal granuloma (OR 3.64), scar tissue formation (OR 2.25), and turbinoseptal synaechia (OR 1.76). The benefits of non-intubation are less patient discomfort, reduced surgical time and costs, simpler follow-up regimen and less intubation-associated complications. En-DCR without silicone stent intubation should be the first choice of procedure, stent intubation should be reserved in selected cases with poor local conditions pre and intra-operatively assessed.

Comparing the Success Rate of Dacryocystorhinostomy With and Without Silicone Intubation: A Trial Sequential Analysis of Randomized Control Trials

“…The ostial size reduction has been reported by Longari et al . in higher percentage in the stent group, mainly due to peristomal granuloma, scar tissue formation, and turbinoseptal synaechia 34 . Owing to data restrictions regarding postoperative complications, which many included trials did not provide, this study only analysed complications quantitatively in term of tissue granulation hyperplasia, infection and adhesion.…”

Endoscopic dacryocystorhinostomy: Comparison of the effectiveness of using sickle knife-micro osteotome and monopolar cautery-Kerrison punch

“…Cerrahi olarak eksternal ve endoskopik yaklaşımlar ve bu yaklaşımların gözyaşı kanalları entübasyonu ve lazerle kombinasyonları tarif edilmiştir [3][4][5] . Son yıllar-da başarı oranlarının artması, eksternal insizyon gerektirmemesi, iyileşme süresinin kısa olması ve lakrimal pompa mekanizmasını bozmaması gibi çeşitli avantajları nedeni ile uygun hastalarda endoskopik dakriyosistorinostomi (EDSR) ameliyatı fazlaca tercih edilmeye başlanmıştır.…”

Combined External-Endoscopic Endonasal Assisted Removal of a Nail Gun

“…5 Blind removal of foreign bodies has been reported, 6 however the development of combined-multiportal endoscopic approaches enabled surgeons to reach different regions through minimally invasive routes with lower incidence of complications, lower morbidity, and mortality rates compared with traditional external approaches. 4,[7][8][9] Reconstruction of anterior skull base defects remains the most challenging issue in this field with postoperative cerebrospinal fluid leak, 9 however, the introduction of different vascularized nasoseptal flaps dramatically decreased the rates of postoperative cerebrospinal fluid leak and improved the quality of life of patients, reducing postoperative nasal crusting and hospitalization time rates ranging from 3.3% to 4.3%. [10][11][12] …”