Revision Endoscopic Dacryocystorhinostomy with Betamethasone Injection under Assisted Local Anaesthetic

Zeldovich, Alina; Ghabrial, Raf

doi:10.3109/01676830903104686

Cited by 24 publications

(16 citation statements)

References 12 publications

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“…Active corticosteroid has been found in subconjunctival depot 13 months after the initial injection [27]. Zeldovich et al reported a high success rate of 89 % in their cohort of revision DCR, in which 1 mg of betamethasone was injected into the lacrimal sac and scar tissue surrounding the ostium during the surgery [13]. Our group had described the insertion of TA soaked gelfoam in our previous cohort of EE-DCR combined in limited nasal septoplasty with a success rate of 96.4 % [14].…”

Section: Discussionmentioning

confidence: 96%

“…Corticosteroid is known to suppress inflammation and fibroblast recruitment, and supposedly reduce scar formation [13]. It was reported that intraoperative administration of corticosteroid resulted in a high success rate [13][14][15]. We propose that the combined use of MMC, which suppresses the proliferative phase of wound healing, and corticosteroid, which suppresses the inflammatory phase, may have synergistic effect in reducing scar formation, thus contracture or blockage of the osteotomy site in EE-DCR.…”

Section: Introductionmentioning

confidence: 95%

“…MMC suppresses the proliferative phase of wound healing and hence scar formation over the ostium created by surgery and was considered a safe and effective adjunct in EE-DCR [12]. Corticosteroid is known to suppress inflammation and fibroblast recruitment, and supposedly reduce scar formation [13]. It was reported that intraoperative administration of corticosteroid resulted in a high success rate [13][14][15].…”

Section: Introductionmentioning

confidence: 98%

See 2 more Smart Citations

Safety and efficacy of adjunctive intranasal mitomycin C and triamcinolone in endonasal endoscopic dacryocystorhinostomy

Cheng

Wong

et al. 2015

Int Ophthalmol

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One of the common causes of failure in dacryocystorhinostomy for nasolacrimal duct obstruction (NLDO) is mucosal scarring and fibrosis around the ostium. Steroid and mitomycin C (MMC) can potentially reduce scarring by their action on the inflammatory and proliferative phase of wound healing, respectively. The purpose of this study is to evaluate the safety and efficacy of combined usage of adjunctive MMC and intranasal triamcinolone (TA) in endonasal endoscopic dacryocystorhinostomy (EE-DCR). This is a retrospective interventional case series. All patients underwent mechanical EE-DCR in two regional hospitals in Hong Kong from January 2005 to December 2006 were included. All received intraoperative MMC application for 5 min and gelfoam soaked with TA onto the ostium. Main outcome measures include the anatomical and functional success rate at follow-up at least 6 months after operation. Other outcomes include complications occurred during and after operation. A total of 73 EE-DCR were performed in 69 patients. Three patients had simultaneous bilateral DCR; one had sequential DCRs for both sides. At the last follow-up, anatomical success was achieved in 68 cases (93 %) and both anatomical with functional success in 67 cases (92 %). No major complication was observed. Minor complications included asymptomatic mucosal adhesion between the nasal septum and lateral nasal wall in one patient and moderate secondary hemorrhage in another. EE-DCR with adjunctive MMC and TA is a safe and successful procedure for the treatment of NLDO.

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Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 95%

Section: Introductionmentioning

confidence: 98%

See 1 more Smart Citation

Safety and efficacy of adjunctive intranasal mitomycin C and triamcinolone in endonasal endoscopic dacryocystorhinostomy

Cheng

Wong

et al. 2015

Int Ophthalmol

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“…Previously reported success rates of endoscopic revision surgery ranged from 60% to 94% [7][8][9][10][11][12][13][14][15].…”

Section: Discussionmentioning

confidence: 99%

Management of Nasolacrimal Duct Obstruction: ENT Surgeon’s Perspective

Chung¹

2017

Korean J Otorhinolaryngol-Head Neck Surg

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Objectives. Endonasal dacryocystorhinostomy (DCR) is a well-established treatment method in patients with nasolacrimal duct obstruction. However, there are a few reports about the overall management of failed endonasal DCR. We investigated the causes and management strategies of failed endonasal DCR.Methods. This retrospective review included 61 patients (61 eyes) who had undergone revision surgery by the same surgeon after failed endonasal DCR between January 2008 and December 2012. The appropriate revision method was determined after analysis of the etiology of failure by the fluorescein dye disappearance test, nasal endoscopy, lacrimal irrigation, and probing. The criteria for success of the revision surgery were defined by the passage of fluid without resistance upon lacrimal irrigation and normalization of the tear meniscus height.Results. The mean duration between the primary endonasal DCR and revision surgery was 15.3 months. The average follow-up period after revision surgery was 12.2 months. The most common cause of endoscopic revision surgery was membranous obstruction. Endoscopic revision surgery was performed in 48 patients, while lacrimal silicone tube intubation under endoscopy was performed in 13 patients. The most common indication for lacrimal silicone tube intubation was functional epiphora. The overall success rate of the revision surgery was 89%. Conclusion.The most common cause of failed endonasal DCR was membranous obstruction. When patients with failed endonasal DCR presented at the clinic, it is important to identify the cause of the failure. Revision surgery could increase the final success rate of endonasal DCR.

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“…Применению кортикостероидов в целях предотвра-щения перифокальной реакции и возможного последую-щего сужения ДС была посвящена работа A. Zeldovich [23]. Известно, что кортикостероиды, оказывая влияние на все фазы иммунного ответа, вызывают как абсолют-ную, так и относительную Т-лимфоцитопению, т.е.…”

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Therapeutic methods of scar prevention at the site of endonasal dacryocystorhinostomy

Atkova

Root

2015

Vestn. oftal'mol.

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Revision Endoscopic Dacryocystorhinostomy with Betamethasone Injection under Assisted Local Anaesthetic

Abstract: Revision endoscopic DCR, under assisted local anaesthetic, had a high success rate (89%) when an injection of betamethasone was administered intraoperatively.

Cited by 24 publications

References 12 publications

Safety and efficacy of adjunctive intranasal mitomycin C and triamcinolone in endonasal endoscopic dacryocystorhinostomy

Safety and efficacy of adjunctive intranasal mitomycin C and triamcinolone in endonasal endoscopic dacryocystorhinostomy

Management of Nasolacrimal Duct Obstruction: ENT Surgeon’s Perspective

Therapeutic methods of scar prevention at the site of endonasal dacryocystorhinostomy

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