Nasolacrimal duct tumours in the era of endoscopic dacryocystorhinostomy: literature review

Tanweer, Faiz; Mahkamova, K; Harkness, P.

doi:10.1017/s0022215113001163

Cited by 23 publications

(18 citation statements)

References 69 publications

(46 reference statements)

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“…In the current study, the large majority of patients who underwent endoscopic DCR were found to have either inflamed or normal‐appearing sac mucosa, consistent with other reported findings of DCR surgery . The unsuspected neoplasms and granulomatous pathology rate in our series was 0.46% (n = 3), compared with 0% to 2.3% reported in the literature . The clinical experience of the senior surgeon in this study may account for this relatively low rate.…”

Section: Discussionsupporting

confidence: 90%

“…2,3,6,7,[13][14][15] The unsuspected neoplasms and granulomatous pathology rate in our series was 0.46% (n = 3), compared with 0% to 2.3% reported in the literature. [2][3][4][5][6][7][8][9][10][11][14][15][16][17][18] The clinical experience of the senior surgeon in this study may account for this relatively low rate. In all three unanticipated cases, the patient history, endoscopic examination, CT imaging, and intraoperative findings were not suggestive of neoplastic or granulomatous inflammation.…”

Section: Discussionmentioning

confidence: 99%

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The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

et al. 2019

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Objectives/Hypothesis Most patients who undergo endoscopic dacryocystorhinostomy (DCR) have a diagnosis of idiopathic nasolacrimal duct obstruction. The purpose of this study was to examine the impact of routine biopsy of the lacrimal sac performed at time of DCR on subsequent patient diagnosis and treatment. Study Design Retrospective review. Methods The histopathology of nasolacrimal specimens (n = 769), obtained from 654 consecutive patients undergoing endoscopic DCR by a single surgeon over a 30‐year period, were reviewed. Specific focus included the identification of unanticipated pathologic findings as they related to pertinent patient demographics, clinical presentation, radiologic findings, and intraoperative observations. Results The study population was 69.6% female, with an average age of 56.1 ± 18.2 years. Pathological findings of tissue from the nasolacrimal sac, which was routinely sampled in all cases, showed inflammation (n = 566 [73.6%]), normal histology (n = 147 [19.1%]), granulomas (n = 8 [1.0%]), and neoplastic process (n = 7 [0.9%]). Patient history, preoperative CT scan, and/or intraoperative findings alerted the surgeon to the possibility of an unusual diagnosis in 12 of the 15 patients. An unsuspected neoplastic or granulomatous cause of lacrimal obstruction was identified on intraoperative biopsy in three patients (0.46%). Conclusions Although neoplastic and granulomatous diseases are relatively rare causes of lacrimal obstruction necessitating DCR surgery, they may be identified by through patient evaluation in most cases and by routine intraoperative biopsy of the lacrimal sac in all cases. Level of Evidence 4 Laryngoscope, 130:584–589, 2020

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Section: Discussionsupporting

confidence: 90%

Section: Discussionmentioning

confidence: 99%

The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

et al. 2019

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“…determined a rate of proliferative diseases of 2.53% (12 tumours) in 474 patients at the Department of Ophthalmology at the Friedrich‐Alexander‐University in Erlangen, Germany. Tanweer et al . postulated a rate of 0.76% (4 neoplasms) in 525 patients .…”

Section: Discussionmentioning

confidence: 99%

Is routine histological tissue sampling during endoscopic dacryocystorhinostomy advantageous? A retrospective analysis of 213 patients

Rauter

Wolf

Walch³

et al. 2018

Clinical Otolaryngology

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“…1 The conditions causing nasolacrimal duct obstruction (NLDO) have an estimated incidence of 66% of all distal acquired forms, 1 and can be caused by different factors such as tumours, auto-immune diseases, systemic therapy (5-fluorouracil administration and iodine-131) and, in the absence of other factors, the stenosis is usually described as primary acquired nasolacrimal duct obstruction (PANDO). [1][2][3][4][5][6][7][8][9][10][11] In the literature different procedures have been described, both surgical and non-surgical, which can be used to treat distal acquired obstruction with a range of success rates. In a recent review, it was pointed out, based on the functional success rates, that external dacryocystorhinostomy (EXT-DCR) and endoscopic endonasal dacryocystorhinostomy (END-DCR) can be considered as the treatments of choice.…”

Section: Introductionmentioning

confidence: 99%

Impact of Post-Surgical Therapies on Endoscopic and External Dacryocystorhinostomy: Systematic Review and Meta-Analysis

Vinciguerra

Nonis

Resti

et al. 2020

Am J Rhinol�Allergy

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Background Epiphora is a common ophthalmologic sign that is most commonly caused by distal acquired lacrimal obstruction. Recent data have demonstrated that external dacryocystorhinostomy (EXT-DCR) and endoscopic endonasal dacryocystorhinostomy (END-DCR) can be considered the treatments of choice. However, different post-surgical medical therapies are available and are currently used to improve surgical outcomes, although no direct comparison has been performed. Objective To analyse the influence of post-surgical medical treatments on END-DCR and EXT-DCR outcomes. Methods A structured search was conducted using the U.S. National Library of Medicine (PubMed), EMBASE, SCOPUS, and Cochrane databases with a final search performed in May 2020. The research identified papers published later than 2000 with at least 50 single clinician procedures performed in EXT-DCR and END-DCR. Articles that studied acute infections, revision cases, mixed cohort studies of acquired and congenital obstruction, and tumour were excluded. The influence of systemic antibiotic/steroids, local application of mitomycin C, nasal/ocular antibiotic, nasal/ocular steroids and nasal decongestants was analysed. Results In total, 11,445 papers were selected, 2,741 of which were reviewed after screening, and 18 included after full text review (0.6% of the initial articles reviewed) which involved 3,590 procedures. Considering the low number of publications on EXT-DCR, statistical analysis of post-surgical therapy was not feasible. In END-DCR, the analyses were performed only for nasal steroids (p = 0.58), oral antibiotics (p = 0.45) and nasal decongestant (p = 0.27), which demonstrated no meaningful influence. Given the variable association between adjunctive medical therapies, pharmacologic molecular heterogeneity and modality/concentration of application, these results should be considered critically. Additionally, no differences were seen for application of silicone stenting, whereas, no statistical analysis was performed for mitomycin C. Conclusions Given the high success rate of EXT-DCR and END-DCR and the heterogeneity of literature data, the effective influence of post-surgical medical therapy is difficult to identify. Future large prospective randomized studies could help in detecting the optimal adjunctive therapy for these surgeries.

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Nasolacrimal duct tumours in the era of endoscopic dacryocystorhinostomy: literature review

Abstract: Since the advent of endoscopic dacryocystorhinostomy, tumours are being diagnosed relatively early when smaller in size. Because of the rarity of this condition, it is advisable that such cases are managed through a dedicated epiphora service framework.

Cited by 23 publications

References 69 publications

The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

The role of routine nasolacrimal sac biopsy during endoscopic dacryocystorhinostomy

Is routine histological tissue sampling during endoscopic dacryocystorhinostomy advantageous? A retrospective analysis of 213 patients

Impact of Post-Surgical Therapies on Endoscopic and External Dacryocystorhinostomy: Systematic Review and Meta-Analysis

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