Endoscopy-Guided Transcaruncular Jones Tube Intubation without Dacryocystorhinostomy

Abstract

Endoscopy-guided Jones tube intubation without DCR is a simple and useful procedure for correcting canalicular obstruction.

Early Experience with the StopLoss Jones Tube

“…Patient satisfaction levels with Jones tube are generally high, typically ranging from 70-100%. 3,4,6,9 However complications have also been frequent, [1][2][3][4]6,7,10,11 limiting the attraction of this treatment to both surgeons and patients. Although many different complications have been described the most frequently encountered are those related to tube positioning, especially extrusion, with rates that are typically higher than the combined rate of all other complications reported with Jones tubes.…”

The survival of an angled extended Jones’ tube

“…Transcaruncular insertion without a DCR implies a reduced cylindrical tract and osteotomy compared with a CDCR. The transcaruncular insertion showed a reduced displacement, mainly nasal, of 7%–26% at a follow-up of approximately 2 years 12 22 23. At final follow-up, 88% of the patients with a well-positioned, patent Jones’ tube reported complete resolution of their epiphora.…”

A novel procedure for treating canalicular obstruction by re-canaliculisation and bicanalicular intubation

“…Common complications include Jones tube extrusion, malposition (towards the eye or into the nose), irritation and pain. Patient discomfort has made some patients refuse re-insertion when extrusion has occurred 1–6 13. Other approaches for canalicular obstruction such as canalicular trephine and laser are associated with few complications and are well tolerated.…”

“…It restores normal anatomical structure and physiological function of the lacrimal drainage system rather than creating a bypassing lacrimal drainage passage. CDCR and DCR with retrograde intubation are more invasive and have a greater risk of complications associated with DCR including intraoperative haemorrhage, trauma, loss of nasal mucosa and scar 13 19. These surgical procedures are difficult to perform 8.…”