Silicone Tubing is not Necessary after Primary Endoscopic Dacryocystorhinostomy: A Prospective Randomized Study

Смирнов, Г. А.; Tuomilehto, Henri; Teräsvirta, Markku; Nuutinen, Juhani; Seppä, Juha

doi:10.2500/ajr.2008.22.3132

Cited by 101 publications

(86 citation statements)

References 19 publications

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“…However, limitations have been reported for both of them, including the potential of silicone intubation to induce an [18][19][20] and the inhibitory effect of MMC on fibroblasts, which potentially limits the regeneration of healthy epithelium. 27,28 Therefore, the ideal agent should promote healthy re-epithelialization without excessive scarring, to ensure ostial patency in DCR.…”

Section: Discussionmentioning

confidence: 99%

“…16,17 Nevertheless, ostial closure or obstruction still occurs, mostly due to excessive scars/synechia or granulation formation at the ostium. 3,5,6,8,9,[18][19][20] Some authors advocate the use of mitomycin C (MMC) intraoperatively to reduce fibrosis formation, [21][22][23][24][25][26] although granulation tissue has been reported to form around the ostia following MMC application during EES-DCR. 27,28 Hyaluronan is a ubiquitous polysaccharide component of the extracellular matrix.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

Cannon

Yan

et al. 2011

Eye

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Purpose To investigate the effects of Merogel coverage on ostial patency in endonasal endoscopic dacryocystorhinostomy (EES-DCR) for primary chronic dacryocystitis (PCD). Methods In all, 260 patients with unilateral PCD were randomized into two groups: the Merogel group and the control group. All patients underwent EES-DCR. The Merogel group received Merogel covering the wound 1-2 mm around the ostium and the control group received no treatment. Patients were followed up for 9 months. The mucosal epithelialization of the wound, the proliferation of fibrosis tissue, and the success rate of ostial patency were compared. Results Our study included 112 patients in the Merogel group and 115 patients in the control group. At the 2-week review, intact mucosal epithelium lined the ostia in 96 Merogel patients compared with 80 control patients (ITT analysis: v 2 ¼ 4.502, P ¼ 0.034). At the 9-month review, scars were present in 18 patients in the Merogel group compared with 39 patients in the control group (ITT analysis: v 2 ¼ 9.909, P ¼ 0.002, ITT analysis). No differences were observed in the granulation formation between the two groups. The success rate of ostial patency reached 94.6% (106/112) in the Merogel group compared with 80% (92/115) in the control group (ITT analysis: v 2 ¼ 4.151, P ¼ 0.042). Conclusion Merogel coverage may enhance the success rate of EES-DCR for PCD by promoting mucosal epithelial healing and preventing excessive scarring.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

Cannon

Yan

et al. 2011

Eye

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“…On purpose to increase the success rate of the procedure, the use of silicone tubes in DCR is quite common (Bousch et al, 1994;Rosen et al, 1997), although its beneficial effects have not been proven unequivocally (Smirnov et al, 2008;Saiju et al, 2009;Feng et al, 2011). On the contrary, silicone intubation has its own set of complications, which includes the infective potential of these stents (Smirnov et al, 2008;Saiju et al, 2009;Feng et al, 2011;Allen et al, 1989).…”

Section: Introductionmentioning

confidence: 99%

Study of microbial growth on silicone tubes after transcanalicular laser-assisted dacryocystorhinostomy and correlation with patency

et al. 2017

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Introduction:Intubation in primary transcanalicular laser assisted dacryocystorhinostomy (TCLADCR) is performed to increase the success rates. However, the associated inflammation and infection can have adverse effects. Objective: To study the microbial infection and drug susceptibility of extubated silicone tubes and final anatomical patency in patients undergoing TCLADCR. Materials and methods: A non-randomised prospective interventional study was conducted in a tertiary care eye centre. The study included twenty consecutive adult patients with primary nasolacrimal duct obstruction. They underwent TCLADCR with bicanalicular silicone intubation. The stents were removed at 2 months and subjected to culture sensitivity, followed by administration of appropriate antimicrobial agents. Main outcome measures studied were the microbial spectrum on the cultured tubes, their sensitivity profile and its correlation with final anatomical patency. Results: A positive culture was obtained in 100% cases, comprising of normal commensals and pathogenic organisms. Of the total 24 isolates, 16 (66.6%) Gram positive bacteria (75% Staphylococcus aureus) and 8 (33.3%) Gram negative bacteria (commonest E.coli) were found, with 4 tubes having more than one isolate. No fungal growth was seen. Ninety percent success rate was achieved at one year following appropriate antimicrobial therapy except in 2 patients with gram negative isolates who had failed to take the prescribed antibiotics following sensitivity reports. There was no correlation between multiple infections and success rate. However, by using the Fisher exact test, a positive correlation was obtained between appropriate antibiotic treatment and the final anatomical patency (p<0.05). Conclusion: Silicone intubation predisposes to microbial growth, which if neglected, can lead to failure of TCLADCR.

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“…However, he did not report whether they were all primary cases. In fact, whereas avoiding stenting is in line with more recent evidence [2,3], silicone tubes are often employed in revision DCR [4].…”

Section: Dear Editormentioning

confidence: 70%

Silicone tube stenting in endonasal dacryocystorhinostomy

Carifi

Zuberbuhler

Carifi

2012

Eur Arch Otorhinolaryngol

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Silicone Tubing is not Necessary after Primary Endoscopic Dacryocystorhinostomy: A Prospective Randomized Study

Abstract: The results of our prospective, randomized study showed that the use of silicone tubes after primary EN-DCR is not necessary.

Cited by 101 publications

References 19 publications

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis

Study of microbial growth on silicone tubes after transcanalicular laser-assisted dacryocystorhinostomy and correlation with patency

Silicone tube stenting in endonasal dacryocystorhinostomy

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