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

Goel, Ruchi; Nagpal, Smriti; Kamal, Saurabh; Kumar, Sushil; Mishra, Bibhabati; Loomba, Poonam

doi:10.3126/nepjoph.v8i2.16992

Cited by 5 publications

(13 citation statements)

References 13 publications

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“…Chronic dacryocystitis is more common in females due to anatomically narrower lacrimal drainage system than in males leading to females coming for DCR more often. In this study as well there were a considerably greater number of female participants (29/6) with p-value of 0.288, which is consistent with previous studies [9][10][11][12][13].…”

Section: Discussionsupporting

confidence: 92%

Complications of Delayed Tube Removal after Dacryocystorhinostomy Surgery in the COVID Era

Pr¹,

Manandhar²,

Paudel³

et al. 2021

JOAR

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Purpose: A silicon stent intubation, done after Dacryocystorhinostomy (DCR) surgery, is generally removed after 6 weeks. However COVID-19 related lockdown as well as recommendation to hold the lacrimal procedures for safety related purpose had led to delay in silicon tube removal for many months. Side effects of even short term silicon stenting are well known. The purpose of this study was to assess the complications of delayed stent removal after DCR surgery, due to COVID restrictions.Materials and Methods: A cross sectional study that included 35 post DCR patients whose silicon tube removal was delayed due to COVID restrictions, was done. Detail history and clinical examination to note the DCR surgery and tube related complications were noted. Silicon tube was removed and syringing done where possible.Result: Mean age was 41 years (SD 14.3; range 7-68 years). Among them, 29(83%) were females. The most common presenting symptom was persistent watering in 19 patients (54.2%); however syringing was found to be patent in 30 patients (85.7%). Out of 35 eyes, 26 (74.3%) had the silicon tube in situ in normal position without puncta or canaliculus complications.The mean (SD) time of delay in tube removal after DCR surgery was 9.5 (2.9) months. The average (SD) delay time in months of study participants who had complications and without complications were 8.3 (2.7) and 10 (2.8) respectively, which was not statistically significant. Conclusion: Delay in silicon tube removal is a safe practice in COVID era.

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Section: Discussionsupporting

confidence: 92%

Complications of Delayed Tube Removal after Dacryocystorhinostomy Surgery in the COVID Era

Pr¹,

Manandhar²,

Paudel³

et al. 2021

JOAR

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“…among our isolates may be linked to the low socioeconomic profile of the patients and poor hygiene habits. Similarly to our results, Nemati et al 18 and Goel et al 19 reported high rates of enteric floral growth among the gram-negative isolates obtained from silicone tubes.…”

Section: Discussionsupporting

confidence: 91%

“…The organisms isolated were not associated with the success rate of DCR in the studies by Ali et al 12 and Goel et al 19 However, Kim et al 13 reported that surgical failure and revision surgeries were associated with Pseudomonas infection. In our study, H. influenzae growth was associated with surgical failure, although we were unable to determine the exact relationship between the surgical failure and H. influenzae growth.…”

Section: Discussionmentioning

confidence: 87%

“…Goel et al 19 conducted a similar study in the Nepalese population and reported 100% positivity in cultures of 24 silicone tubes. Of the total isolates, gram-positive bacteria were found in 66.6% and gram-negative bacteria in 33.3% of the tubes, while no fungi were isolated.…”

Section: Discussionmentioning

confidence: 92%

“…The most common gram-positive isolate was S. aureus (50%) and the most common gram-negative isolate was E. coli (20.8%). 19 …”

Section: Discussionmentioning

confidence: 99%

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The Microbiological Profile of Bicanalicular Silicone Tubes Placed During External Dacryocystorhinostomy

Özcan¹,

Hoşal²,

Gerçeker³

2021

tjo

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Objectives: To identify microbiological growth on bicanalicular silicone tubes (BST) placed during dacryocystorhinostomy (DCR) surgery and to analyze the association between culture results and surgical outcomes and BST removal time. Materials and Methods: A total of 80 lacrimal drainage systems of 68 patients who had external DCR with bicanalicular silicone intubation were included the study. Twenty-five tubes (31.3%) were removed up to 8 weeks, 28 tubes (35.0%) were removed between 9 and 11 weeks, and the remaining 27 tubes (33.7%) were removed 12 weeks or more after surgery. The tubes were transferred to Stuart medium and sent for microbiologic examination. The disc diffusion method was used to determine antibiotic resistance. Results: Culture positivity was observed for 96.2% of the tubes. Among a total of 109 isolates, 63 were gram-positive bacteria (57.8%), 37 were gram-negative bacteria (34%), and 9 were fungi (8.2%). The most commonly isolated gram-positive and gram-negative bacteria were Staphylococcus aureus (66.6%) and Enterobacter spp. (29.7%), respectively. Penicillin, clindamycin, erythromycin, and tetracycline resistances were higher among gram-positive pathogens. Cephalothin, amoxicillin-clavulanic acid, and ampicillin resistances were higher among gram-negative pathogens. There was no significant difference in terms of the microbiological profile between the three groups of removed tubes. Haemophilus influenzae was isolated at a significantly higher rate in patients with surgical failure (p=0.04). Conclusion: Although a variety of agents were isolated from removed BST, gram-positive organisms were more frequent than gramnegatives and fungi. S. aureus and Enterobacter were the most common gram-positive and gram-negative isolates. Later BST removal was associated with the isolation of significantly more bacterial strains per tube. There was no correlation between multiple infections and surgical failure. H. influenzae was more common in failed DCR cases.

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Should Silicone Lacrimal Stenting be a Better Choice for Primary Endoscopic Powered Dacryocystorhinostomy?

Dutta

Ghatak

Bandyopadhyay

2022

Indian J Otolaryngol Head Neck Surg

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Objective : To compare endoscopic dacryocystorhinostomy (EnDCR) with and without silicone lacrimal stenting through subjective (patients’) and objective (surgeons’) outcome parameters. Methodology : Following defined selection criteria, EnDCR was performed on patients with primary chronic dacryocystitis with post-saccal stenosis. Every alternate patient had silicone lacrimal stenting (group A: no stenting; group B: with stenting); stents were removed at three months. At six months (minimum follow-up period), patients’ responses on symptom relief (through a five-point score) and naso-endoscopic evaluation (visualization of rhinostome; presence of granulations and synechiae; lacrimal drainage patency by estimating methylene blue flow pattern) were compared between the groups. Results : Each group had 20 patients. There was no statistically significant difference in group-wise follow-up periods. Five-point score at six months revealed 85% and 95% of patients in groups A and B, respectively, experienced “success”; among them, 60% and 75% were “symptom-free”. The majority (75%) in group B experienced no discomfort from stenting. Naso-endoscopy revealed 80% patients in group A and 65% in group B had well-delineated rhinostome, albeit with granulations in 25% and 50%, respectively. Spontaneous dye flow was achieved, respectively, in 75% and 90%. The difference in none of the subjective and endoscopic parameters achieved statistical significance. None had synechia; fibrosis was seen in the four patients with no dye flow even with pressure/massaging. Conclusion : There was no statistically significant difference in EnDCR with and without silicone lacrimal stenting in the overall outcome of symptomatic improvement and endoscopic assessment of the surgical site.

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

Cited by 5 publications

References 13 publications

Complications of Delayed Tube Removal after Dacryocystorhinostomy Surgery in the COVID Era

Complications of Delayed Tube Removal after Dacryocystorhinostomy Surgery in the COVID Era

The Microbiological Profile of Bicanalicular Silicone Tubes Placed During External Dacryocystorhinostomy

Should Silicone Lacrimal Stenting be a Better Choice for Primary Endoscopic Powered Dacryocystorhinostomy?

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