Symptom score questionnaire for nasolacrimal duct obstruction in adults--a novel tool to assess the outcome after endoscopic dacryocystorhinostomy

Abstract

BACKGROUND: The incidence of nasolacrimal pathway obstruction increases with age, and dacryocystorhinostomy (DCR) is a commonly applied surgical technique to treat severe cases. However, no disease-specific tools to assess the symptoms and the subjective outcome after DCR have been established. We have developed a specific Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS) questionnaire to evaluate the outcome, and tested it in a prospective clinical trial. STUDY DESIGN: Prospective clinical follow-up study. METHODS: Sixty-eight consecutive primary endoscopic dacryocystorhinostomy (EN-DCR) procedures were performed in 64 patients during 2004-2008. Preoperatively and during the three follow-up visits (at 1 week, 2 and 6 months), the patients filled in the NLDO-SS, and at the second and third follow-up visits they also filled in the Glasgow Benefit Inventory (GBI) questionnaire. At one year after the operation, a GBI questionnaire was sent to the patients. RESULTS: The surgical success rate of EN-DCR was 93 %. EN-DCR resulted in a significant reduction in all of the eight symptoms scores of the NLDO-SS (p= 0.001). The GBI scores indicated a significant benefit at 2 months (+37 (SD; 28) and an even higher benefit at 6 months after surgery (+52 (SD; 29), p= 0.001), but no further improvement was found between 6 and 12 months (+52 vs +52, p= 1.0). The correlation between the total GBI and NLDO-SS was significant (p=0.001). CONCLUSIONS: EN-DCR significantly improves the quality of life as measured by the GBI. The NLDO-SS correlated with the GBI and gave more information about the benefits after EN-DCR than GBI alone. The NLDO-SS proved to be an effective tool to evaluate lacrimal obstructions and EN-DCR benefits. Further studies to validate NLDO-SS are needed.

QoL Following Dacryocystorhinostomy: Linguistic Adaptation of Italian Version of GBI

“…In the literature there are two questionnaires not translated or validated in Italian, the Lac-Q (Lacrimal symptom questionary) and the NLDO-SS (Nasolacrimal duct obstruction-symptom score), designed to evaluate the success of the DCR intervention [ 13 , 14 ]. Although they are more specific for the symptoms resulting from obstructive tear pathology, the GBI can evaluate both the symptoms due to the disease and the psychological and social features.…”

Application of a symptoms score questionnaire after conjunctivodacryocystorhinostomy: outcomes

“…In our retrospective study, we decided to employ NLDO-SS to assess patient satisfaction after an anatomically and surgically successful CDCR procedure. NLDO-SS was originally conceived by Smirnov et al 5 to assess outcomes after treatment naso-lacrimal duct obstructions, and we decided to apply the score to our patients since nasolacrimal duct obstruction and canalicular obstruction share the same plethora of symptoms 14 , and both the anatomical subsites participate as a whole to the lacrimal drainage system. NLDO-SS is not the only tool available to assess postsurgical QoL: Glasgow Benefit Inventory (GBI) and Lacrimal Symptoms Questionnaire (Lac-Q) are also widely used.…”

“…Patients were guided through the questionnaire by the interviewer. The NLDO-SS questionnaire 5 consists of five items focusing on the common ocular symptoms of NLDO: tearing, discharge in the eye, swelling around the eye, pain around the eye, change in visual acuity; along with two items describing the conditions in the nasal cavity: nose blockage, nasal cavity discharge (Tab. I).…”

Evaluation of the relationship between tear meniscus changes and quality of life outcomes after external dacryocystorhinostomy

“…[3][4][5][6][7][8][9] Ramey et al performed a systematic review of outcome measures reported by all oculoplastic patients and were able to identify only two validated lacrimal surgery questionnaires, the Nasolacrimal Duct Obstruction Symptom Score (NLDO-SS) and the Lac-Q questionnaire, both of which are speci c to DCR surgery. [10][11][12] Therefore, this prospective study aimed to investigate the changes in tear meniscus parameters following external DCR surgery in patient with NLDO. Additionally, we assessed the association between these changes and improvements in quality of life outcomes.…”