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

Delaney, Yvonne; Khooshabeh, R

doi:10.1136/bjo.86.5.533

Cited by 81 publications

(81 citation statements)

References 15 publications

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“…[2,12,23] The global value for success rate of DCR with Silicone intubation in DCR cases with high failure rate is 85% out of which it is 90% post traumatic cases and 83% in failed DCR cases [12]. On comparing these global values with results of our study, utilizing the Z test for proportions again confirms the significance of this procedure.…”

Section: Discussionsupporting

confidence: 72%

“…Time has witnessed many modifications in the procedure as described by Adeo Toti, an ophthalmologist in 1904 almost a century ago, but the basics remain the same [1]. The success rate of external DCR has been reported up to 90% depending upon the surgeon's experience [2]. Various other methods have also been adopted successfully such as endoscopic DCR, endonasal laser DCR, dacryocystoplasty and Radio Frequency assisted DCR [3][4][5][6].…”

Section: Introductionmentioning

confidence: 99%

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Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

Rizvi

Sharma

Tripathy

et al. 2011

Indian J Otolaryngol Head Neck Surg

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The aim of this work is to study the management and success rate of traumatic dacryocystitis and failed dacryocystorhinostomy (DCR) using Silicone lacrimal intubation set. A prospective study was conducted at a tertiary eye care hospital, India from February 2006 to January 2008. This study material comprised 50 patients of traumatic dacryocystitis and failed dacryocystorhinostomy. Anterior single flap external dacryocystorhinostomy with Silicon intubation was performed in all the patients. The patients were followed up at weekly intervals for 1 month and thereafter every 2 months for 1 year post operatively. Criteria determining success were based on resolution of epiphora and patency on syringing. In traumatic dacryocystitis, 21(91.3%) cases fulfilled these criteria while 23(85.2%) cases of failed DCR were successful. The overall success rate (88%) was determined with an average follow-up of 1 year. Globally, the technique was effective in 85% of cases. The results were comparable with other similar studies. This study concludes that performing a DCR in traumatic dacryocystitis and failed DCR taking into consideration the complications and chances of failure is a challenge for the surgeon. We opine that External dacryocystorhinostomy with Silicon Intubation is one of the most effective modality in dealing with such cases.

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Section: Discussionsupporting

confidence: 72%

Section: Introductionmentioning

confidence: 99%

Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

Rizvi

Sharma

Tripathy

et al. 2011

Indian J Otolaryngol Head Neck Surg

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“…Estudos avaliando a DCR externa em adultos mostram melhora dos sintomas em cerca de 90,0% dos pacientes (12)(13) . Valores semelhantes são apontados quando se trata de DCR endoscópica (14)(15) .…”

Section: Discussionunclassified

Dacriocistorrinostomia externa em crianças

Ferraz¹,

Schellini²,

Sakamoto³

et al. 2003

Arq. Bras. Oftalmol.

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Objetivo: Avaliar a eficácia da dacriocistorrinostomia (DCR) externa realizada em crianças. Métodos: O estudo foi retrospectivo, avaliando-se 16 crianças com idade inferior a 10 anos, portadoras de obstrução da via lacrimal e submetidas a DCR externa, no período de 1986 até 2001. Foram avaliadas as características dos portadores, as queixas apresentadas, o exame e o tipo de cirurgia efetuada, assim como o resultado do tratamento. Resultado: A amostra estudada não diferiu quanto ao sexo e faixa etária. A cirurgia mais realizada foi DCR sem o uso de entubação de vias lacrimais (87,5%). 62,5% tiveram resolução da epífora com um único procedimento e 81,0%, com dois. Conclusão: O resultado da DCR externa, quando realizada em crianças, é semelhante ao observado em adultos. A epífora pode ocorrer em crianças, quando, em grande parte, decorre de obstrução do ducto nasolacrimal devido à persistência da membrana de Hasner ou estenose do sistema de drenagem lacrimal abaixo do saco lacrimal (1)(2) . External dacryocystorhinostomy in childrenO quadro clínico de epífora e secreção pode ter resolução espontânea na grande maioria dos portadores (1) . Quando isso não ocorre, massagens e/ou antibioticoterapia tópica podem ser úteis.No entanto, em poucos casos há persistência dos sintomas e aparecimento de quadros infecciosos, tornando necessário utilizar tratamentos intervencionistas, como a sondagem das vias lacrimais, a entubação, a dilatação intracanalicular usando cateter balão e a dacriocistorrinostomia (DCR) (3)(4) .Quando a sondagem e a entubação não apresentam resultados satisfatórios ou quando há dacriocistite aguda, a DCR pode ser realizada pelas vias externa ou endonasal (2,5) .No entanto, poucos são os relatos enfocando a resolutibilidade da cirurgia quando realizada em crianças.Assim, o objetivo deste estudo é avaliar a eficácia da DCR externa, realizada como tratamento da obstrução de vias lacrimais, em crianças abaixo de 10 anos. MÉTODOSForam avaliadas retrospectivamente 16 crianças (16 vias lacrimais) com idade inferior a 10 anos, portadoras de obstrução das vias lacrimais e submetidas a DCR externa no Hospital das Clínicas de Botucatu/UNESP, entre os anos de 1986 e 2001.

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“…[1][2][3][4][5] In the scientific literature, there are large gaps in our understanding of what benefit endoscopic DCR (EES-DCR) offers in partial NDO from clinical studies as opposed to anecdotal evidence, as summarised in Table 1. 3-5 The current study addresses two significant deficiencies in the evidence base. First, no prospective study had hitherto looked at the outcome of EES-DCR in the treatment of partial obstruction of the nasolacrimal system.…”

Section: Introductionmentioning

confidence: 99%

A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction

Zaidi

Symanski

Olver

2011

Eye

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Objective A literature review revealed there is no outcome data for endoscopic endonasal dacryocystorhinostomy (EES-DCR) in the subgroup of patients with acquired partial nasolacrimal duct obstruction (NDO). This study aimed to compare the results of EES-DCR vs external DCR (ext-DCR) in the treatment of partial NDO. Design This study is designed as a prospective nonrandomised comparative clinical trial. Participants In total, 46 adult patients with acquired partial NDO participated in this study. Methods Partial (sometimes called 'functional') NDO (epiphora in the presence of patent syringing) was confirmed by nuclear lacrimal scintigraphy or delayed drainage on dacryocystography. Patients with 'functional' epiphora from other causes were excluded. Post-operative outcome was assessed at 6 months. Overall, 21 (46%) patients had EES-DCR and 25 patients had (54%) ext-DCR. Main Outcome Measures Subjective success was based on patient symptoms, objective success on patency with syringing and a functioning rhinostomy evaluated using the functional endoscopic dye test (FEDT). Results In total 18 out of 21 (86%) of EES-DCR patients had marked reduction (n ¼ 11) or complete resolution (n ¼ 7) and 25 out of 25 (100%) of ext-DCR had marked reduction (n ¼ 9) or complete resolution (n ¼ 16) of epiphora. In total 17 out of 18 (94%) of the EES-DCR patients with subjective success had a positive FEDT. All 25 out of 25 (100%) ext-DCR patients with subjective success had a positive FEDT. The three failed EES-DCR patients were all blocked on syringing. Statistically, EES-DCR does not achieve the same success rate as ext-DCR in this study (P ¼ 0.09, two-tailed Fisher's exact test, 0.045 one-tailed). Conclusions Both endoscopic and external DCRs provide satisfactory outcomes in acquired partial NDO. The success rate is nevertheless higher in ext-DCR compared with EES-DCR.

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

Cited by 81 publications

References 15 publications

Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

Management of Traumatic Dacryocystitis and Failed Dacryocystorhinostomy Using Silicone Lacrimal Intubation Set

Dacriocistorrinostomia externa em crianças

A clinical trial of endoscopic vs external dacryocystorhinostomy for partial nasolacrimal duct obstruction

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