Transcanalicular endoscope combined laser-assisted dacryocystorhinostomy

Abstract

Aims:In this study, we have tried to assess the success rate and difficulties that we came across while performing the transcanalicular endoscope combined laser-assisted dacryocystorhinostomy (T-ECLAD).Materials and Methods:A prospective study of 60 patients suffering from nasolacrimal duct obstruction confirmed by preoperative syringing was carried out at the Regional Institute of Ophthalmology. T-ECLAD is a new minimally invasive dacryocystorhinostomy procedure, which is performed by diode laser (980 nm diode laser with power of 10 watts) through lacrimal canaliculi with the help of a cannula and fiber optic cable. The interior of the nasal cavity was visualized with the help of the nasal endoscope on a monitor. Success of procedure was assessed by patency of the lacrimal drainage system on irrigation.Results:We performed 56 successive T-ECLAD. The average procedure time was 10 min, and on an average 235 Joules of laser energy was needed. We observed a patent nasolacrimal duct on irrigation in 39 out of 56 treated eyes. 1 patient had partial, 5 patients had blocked irrigation, and 10 patients did not return for follow up. This yields a success rate of 69.6% (if we exclude patients who did not return for follow up) with an average follow-up period of 6 months.Conclusions:The 980-nm T-ECLAD is a new contribution to the field of lacrimal surgery. It is a minimally invasive and quick procedure.

Endoscopic dacryocystorhinostomy: Comparison of the effectiveness of using sickle knife-micro osteotome and monopolar cautery-Kerrison punch

“…Cerrahi olarak eksternal ve endoskopik yaklaşımlar ve bu yaklaşımların gözyaşı kanalları entübasyonu ve lazerle kombinasyonları tarif edilmiştir [3][4][5] . Son yıllar-da başarı oranlarının artması, eksternal insizyon gerektirmemesi, iyileşme süresinin kısa olması ve lakrimal pompa mekanizmasını bozmaması gibi çeşitli avantajları nedeni ile uygun hastalarda endoskopik dakriyosistorinostomi (EDSR) ameliyatı fazlaca tercih edilmeye başlanmıştır.…”

Endoscopic Transcanalicular Laser Dacryocystorhinostomy in Primary Nasolacrimal Duct Obstruction

“…14 Pal ve ark., ETLDSR başarı oranını 24 aylık izlemde %69,6 olarak saptamışlardır. 20 Zengin ve ark. ise 43 hastadan oluşan çalışmalarında, ortalama 19,4 ay izlemde %83,7 ETLDSR başarı oranı bildirmiş-lerdir.…”

Postoperative Changes in Olfactory Function After Transcanalicular Diode Laser Dacryocystorhinostomy

“…The mean surgical time was 12.5 minutes (range [8][9][10][11][12][13][14][15][16]. The fiber was inserted through the lower canaliculus until it reached the wall of the sac.…”

“…[2][3][4] In this approach, a probe is inserted through the lacrimal punctum via the canaliculus into the lacrimal sac following the anatomical pathway of tear outflow. [6][7][8][9][10] This procedure is a minimally invasive approach that has been shown to promote nasolacrimal patency. [4][5][6] Transcanalicular diode laser dacryocystorhinostomy (TCL-DCR) has been used much in recent years.…”

“…Osteotomy is performed by mechanical tool or laser energy through an optic fiber inserted within the probe. 10,11 Although TCL-DCR is accepted to be minimally invasive, safe, and an effective method for NLDO, there is no report focusing on olfactory function in patients who have undergone TCL-DCR. [6][7][8][9][10] This procedure is a minimally invasive approach that has been shown to promote nasolacrimal patency.…”