External Dacryocystorhinostomy With or Without Double Mucosal Flap Anastomosis

Takahashi, Yasuhiro; Mito, Hidenori; Kakizaki, Hirohiko

doi:10.1097/scs.0000000000001557

Cited by 9 publications

(6 citation statements)

References 16 publications

(19 reference statements)

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“…We previously reported that the ex-DCR with two-flap anastomosis provided a 93.0% success rate (53 of 57 sides) and the ex-DCR without flap anastomosis success rate was 93.2% (138 of 148 sides) at postoperative 12 months 17. Another study of an endonasal DCR without flap preservation reported that 92.2% success (375 of 407 sides) was achieved at postoperative 3 months 18.…”

Section: Discussionmentioning

confidence: 99%

Eight-flap anastomosis in external dacryocystorhinostomy

2015

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Section: Discussionmentioning

confidence: 99%

Eight-flap anastomosis in external dacryocystorhinostomy

2015

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“…This lack of difference may be linked to the excision of the posterior flap. However, Takahashi et al reported comparable surgical outcomes between external DCR with double-flap anastomosis and flapless surgery [ 14 ], which indicates that even with preservation of the posterior flap, flapless external DCR could have a comparable success rate.…”

Section: Discussionmentioning

confidence: 99%

“…The one-flap technique was reportedly as effective as the two-flap technique [ 12 ]. Currently, there is a new modification described by several authors, in which external DCR is performed with neither anterior nor posterior flaps [ 13 , 14 ].…”

Section: Introductionmentioning

confidence: 99%

Comparing the success rate of external dacryocystorhinostomy with anterior flap versus flap excision in managing chronic dacryocystitis

Mansour¹,

Hassan²,

Tharwat³

et al. 2023

Med Hypothesis Discov Innov Ophthalmol

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Background: Nasolacrimal duct obstruction (NLDO) is characterized by epiphora and recurrent episodes of acute dacryocystitis. Despite the temporary effect of antibiotics in the acute phase, it is primarily managed by dacryocystorhinostomy (DCR). There is a new modification of external DCR that is performed without either anterior or posterior flaps. This study aimed to compare the outcomes of flapless and single-flap external DCR in adult patients with chronic symptomatic dacryocystitis secondary to NLDO. Methods: In this retrospective, non-randomized, interventional, comparative study of patients with chronic dacryocystitis secondary to primary acquired NLDO, we compared the surgical outcomes and complication rates of flapless external DCR to those of external DCR with only anterior flap suturing. We excluded patients who declined participation and those with soft stops, nasal problems, lid margin abnormalities, lid malposition or laxity, previous lacrimal surgery, lacrimal fistula, trauma involving the lacrimal drainage system, lack of adequate follow-up, or severe septal deviation or turbinate hypertrophy. Anatomical and functional success rates were determined at the last follow-up visit and were compared. Postoperative complications were recorded and compared between groups. Results: We included 53 patients with a male-to-female ratio of 16 (30.2%) to 37 (69.8%); 25 eyes underwent flapless DCR (group 1) and 28 eyes underwent anterior flap suturing DCR (group 2). The two groups had comparable demographic characteristics (all P > 0.05). Furthermore, anatomical (92.0% in group 1 and 92.9% in group 2) and functional (84.0% in group 1 and 92.9% in group 2) success rates at final follow-up were comparable between groups (both P > 0.05). At the one-month postoperative examination, premature tube extrusion was more often reported in group 1 (12.0%) compared to group 2 (7.1%). At the two-month follow-up examination, tube extrusion was noted in 4.0% in group 1 and 0.0% in group 2, yet the difference failed to attain statistical significance (P > 0.05). Conclusions: We found that neither surgical method was superior in terms of anatomical or functional success rate at a maximum of one year after external DCR. Flapless DCR is a simple, effective, and reproducible alternative to the single anterior flap suturing technique for managing NLDO in adults with chronic dacryocystitis. However, further randomized clinical trials with larger sample sizes and longer follow-up periods are recommended before generalization can be justified.

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“…External DCR without flap anastomosis has also been applied in a majority of cases in a study done by Takahashi et al 5 This technique demonstrated a success rate as good as external DCR with double-flap. The author compared the surgical outcomes of 205 external DCR surgeries divided into double-flap group and no-flap group.…”

Section: Discussionmentioning

confidence: 99%

External dacryocystorhinostomy

Long¹,

Khialdin²,

Azli³

2019

Asian JO

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Aim: To analyse the epidemiological data, surgical technique, success rate, and complications of patients who underwent external DCR in Hospital Selayang from January 2015 to December 2016. Method: Retrospective case series. Results: A total of 21 eyes of 20 patients who underwent external DCR from January 2015 to December 2016 were identified and reviewed. There were 15 females (75%) and 5 males (25%). Age ranged from 5 to 75 years old, with a median age of 56 years old (IQR 23). Twelve patients presented with epiphora while eight patients presented with symptoms of dacryocystitis. One case was congenital, two were secondary nasolacrimal duct obstruction and the rest were primary nasolacrimal duct obstruction. All patients underwent external DCR under general anaesthesia. Silicone tube were inserted in 21 eyes, of which all were removed 3 months after the surgery except one patient whom had his tube dislodged accidentally. The overall success rate was 90.5% (n = 19), which was defined as no or minimal intermittent epiphora or no reflux on lacrimal irrigation at 12 months postoperative. There was one patient who had a cerebrospinal fluid leak treated successfully with intravenous antibiotics. Conclusion: The surgical success rate for external dacryocystorhinostomy was comparable to that of the global success rate of external DCR. This is attributed to the application of surgical technique such as anterior suspended flap modification and posterior flap excision.

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External Dacryocystorhinostomy With or Without Double Mucosal Flap Anastomosis

Cited by 9 publications

References 16 publications

Eight-flap anastomosis in external dacryocystorhinostomy

Eight-flap anastomosis in external dacryocystorhinostomy

Comparing the success rate of external dacryocystorhinostomy with anterior flap versus flap excision in managing chronic dacryocystitis

External dacryocystorhinostomy

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