Long‐term outcomes of powered endoscopic dacryocystorhinostomy in acute dacryocystitis

Chisty, Naja; Singh, Manpreet; Ali, Mohammad Javed; Naik, Milind N.

doi:10.1002/lary.25380

Cited by 33 publications

(21 citation statements)

References 24 publications

(99 reference statements)

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“…Table V shows a summary of sample sizes, follow-up lengths, and success rates in leading articles. Data on long-term outcomes for eDCR were reported to a lesser extent, 13,17,19,20 and none have 10-year follow-up for DCR in general and eDCR specifically.…”

Section: Discussionmentioning

confidence: 99%

Five‐ and 10‐Year Outcomes for Primary Endoscopic Dacryocystorhinostomy: Failure Rate and Risk Factors

et al. 2020

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Introduction Endoscopic dacryocystorhinostomy (eDCR) is the preferred approach for nasolacrimal duct obstruction, yet quality data on long‐term outcomes is lacking. Study Design A retrospective study in a single, academic institution. Objective To assess the 5‐ and 10‐year success rates of eDCR, and its associated risks. Patients and Methods All eDCRs conducted at Kaplan Medical Center between the years 2002–2017 were included. For long‐term follow‐up analysis, two subgroups with a minimum of documented 5‐ and 10‐year follow‐up after surgery were defined. Surgical success was defined by both anatomical (observed patent lacrimal flow) and functional (symptomatic relief) success. Data was collected from the hospital's electronic medical records and was completed by phone interviews. Pre‐, intra‐, and postoperative variables were collected and stratified by multivariate analysis. Results After exclusions, 321, 168, and 65 patients were included for immediate, 5‐ and 10‐year outcome analysis, respectively. Overall success rates were 92.5%, 86.3%, and 80%, respectively. The anatomical success rates were 93.8%, 89.9%, and 86.1%, respectively. Multivariate analysis revealed that older age (P < .001, P = .001) previous smoking (P = .043, P = .037), and postoperative complains of epiphora (even when a successful irrigation was observed, P < .001, P = .01) were all associated with eDCR failure 5 and 10 years following surgery. Male gender was also associated with eDCR failure (5 years, P = .045; 10 years, P = .063). Conclusions Despite decreased rates over time, eDCR is beneficial for the majority of patients also at 10 years following surgery. Older age, smoking, postoperative epiphora, and male gender are related to long‐term failure and should be discussed with the patients before surgery. Level of Evidence 3b Laryngoscope, 131:10–16, 2021

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Section: Discussionmentioning

confidence: 99%

Five‐ and 10‐Year Outcomes for Primary Endoscopic Dacryocystorhinostomy: Failure Rate and Risk Factors

et al. 2020

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“…All patients in the current cohort underwent intubation and mitomycin C (0.02% for 3 minutes) as described earlier. 20 , 21 Stents were retained for 4 weeks. Postoperatively, these patients required more frequent saline nasal douching (thrice a day) and weekly crust cleaning (for 4 weeks) compared to regular EnDCR.…”

Section: Methodsmentioning

confidence: 99%

Entire lacrimal sac within the ethmoid sinus: outcomes of powered endoscopic dacryocystorhinostomy

Ali

Singh

Naik

2016

OPTH

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BackgroundThe aim of this study was to report the outcomes of powered endoscopic dacryocystorhinostomy (PEnDCR) in patients with lacrimal sac within the sinus.Materials and methodsRetrospective analysis was performed on all patients who underwent PEnDCR and were intraoperatively documented to have complete lacrimal sac in sinus. Data collected included demographics, clinical presentations, associated lacrimal and nasal anomalies, intraoperative findings, intraoperative guidance, complications, postoperative ostium behavior, and anatomical and functional success. A minimum follow-up of 6 months postsurgery was considered for final analysis.ResultsA total of 17 eyes of 15 patients underwent PEnDCR using standard protocols, but with additional intraoperative guidance where required and careful maneuvering in the ethmoid sinus. The mean age of the patients was 37.2 (range 17–60) years. Of the unilateral cases, 69% (nine of 13) showed left-side predisposition; 80% of patients showed regurgitation on pressure over the lacrimal sac area. Associated lacrimal and nasal anomalies were observed in 13.3% (two of 15) and 40% (six of 15), respectively. At a mean follow-up of 6.6 months, anatomical and functional success were observed in 93.3% (14 of 15). One patient showed failure secondary to cicatricial closure of the ostium.ConclusionAn entire sac within an ethmoid sinus poses a surgical challenge. Good sinus-surgery training, thorough knowledge of endoscopic anatomy, careful maneuvering, and use of intraoperative navigation guidance result in good outcomes with PEnDCR.

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“…No increased frequency of safety issues and operation time was identified, and anatomical and functional success appeared comparable between the two treatments [23]. Kamal et al [21] reported anatomical success in 95% (19/20) and functional success in 90% (18/20) of the patients in their prospective interventional case series of 20 primary powered En-DCRs that were performed in patients presenting with acute dacryocystitis and lacrimal sac abscess and these benefits were maintained even at long-term clinical reviews [24].…”

Section: Acute Dacryocystitis And/or Lacrimal Abscessmentioning

confidence: 98%

The importance of endoscopy in lacrimal surgery

Nair

Singh

Kamal³

et al. 2018

Expert Review of Ophthalmology

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Introduction: The utilization of endoscopy in lacrimal surgeries has been increasing in the recent past with increasing indications. With the advent of newer generation of telescopes, the practice and learning of endoscopic lacrimal surgeries is expected to improve further. Areas covered: This review provides an overview about endoscope assistance in all conditions that involve pathologies of the lacrimal drainage apparatus. The authors have reviewed recently published literature on the techniques and outcomes of endoscopic dacryocystorhinostomy (DCR) in different scenarios such as acute dacryocystitis, pediatric cases, cases with sinonasal anomalies, traumatic nasolacrimal duct obstructions (NLDO) and revision DCRs. Furthermore, promising new avenues such as the 3D endoscopes, variable viewing endoscopes, dacryoendoscopes, navigation-assisted and augmented reality endoscopic lacrimal surgeries have been discussed. Expert commentary: The aim for clinicians should now move on to addressing lacrimal pathologies with traditionally less favorable outcomes and reducing the failure rates with the technological assistance. As more ophthalmology training programs include structured training modules on endoscopic lacrimal surgery, the popularity, the safety and indications of endoscopic lacrimal surgery by ophthalmologists is expected to increase.

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Long‐term outcomes of powered endoscopic dacryocystorhinostomy in acute dacryocystitis

Abstract: 4. Laryngoscope, 126:551-553, 2016.

Cited by 33 publications

References 24 publications

Five‐ and 10‐Year Outcomes for Primary Endoscopic Dacryocystorhinostomy: Failure Rate and Risk Factors

Five‐ and 10‐Year Outcomes for Primary Endoscopic Dacryocystorhinostomy: Failure Rate and Risk Factors

Entire lacrimal sac within the ethmoid sinus: outcomes of powered endoscopic dacryocystorhinostomy

The importance of endoscopy in lacrimal surgery

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