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Evaluation of Endoscopic Dacryocystorhinostomy Success Rate in Patients with Nasolacrimal Duct Obstruction (2015-18)
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Masoumeh Eslami    1, Fatemeh Abdi2 , Marjan Akbari-Kamrani3 , Arzhang Gordiz4 , Fatemeh Najafi5 |
1- Assistant Professor of Otorhinolaryngology, Department of Surgery, Clinical Research Development Unit (CRDU),5th Azar Hospital, Golestan University of Medical Sciences, Gorgan, Iran. , drmes63@gmail.com
2- Assistant Professor of Ophthalmology, Eye Research Center, Iran University of Medical Science, Tehran, Iran.
3- Assistant Professor of Ophthalmology, Department of Surgery, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran.
4- Ophthalmologist, Eye Research Center, Iran University of Medical Science, Tehran, Iran.
5- General Physician, School of Medicine, Golestan University of Medical Sciences, Gorgan, Iran. |
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Abstract: (936 Views) |
Background and Objective: Any factor that disrupts the tear duct can cause epiphora, one of the most prevalent causes for patients to go to ophthalmology clinics. Nasolacrimal duct obstruction can be congenital or acquired. Dacryocystorhinostomy (DCR) surgery, which can be operated using external or endonasal approaches, is the standard treatment for nasolacrimal duct obstruction. This study was carried out to assess the success rate of endoscopic dacryocystorhinostomy surgery for patients with nasolacrimal duct obstruction.
Methods: This descriptive study was carried out on 38 patients (29 females and 9 males), aged over 18 with an average age of 43.07±13.83, suffering from epiphora referring to 5 Azar Hospital in Gorgan (Iran) between 2015 and 2018. The success rate of endoscopic dacryocystorhinostomy surgery for epiphora treatment was evaluated 6 months after the surgery. Furthermore, from the viewpoint of the complications of the surgery and the connection to the CT scan results, endoscopic dacryocystorhinostomy surgery was assessed.
Results: The surgery was successful for 36 patients (94.74%). The extent of the nasolacrimal duct obstruction of the right eye and the left eye was measured at 63.2% and 36.8%, respectively. Slight and heavy bleeding during the surgery was observed in 76.3% and 7.9% of the cases, respectively. Cerebrospinal fluid leakage and orbital injury during the surgery were not seen in the patients. According to the CT scan findings, deviation of the septum was seen in 76.3% of the patients, while septoplasty was operated on in 41.37% of the patients during the surgery. Moreover, half of the patients were suffering from chronic sinusitis for whom, the involved sinuses were opened and sinuses drainage was performed.
Conclusion: Endoscopic dacryocystorhinostomy surgery is an acceptable and successful method for treating epiphora, especially for patients with sinusitis or nasal septum deviation.
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Keywords: Lacrimal Apparatus Diseases [MeSH], Dacryocystorhinostomy [MeSH], Endoscopy [MeSH]
Article ID: Vol24-44 |
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Full-Text [PDF 504 kb]
(5998 Downloads)
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Type of Study: Short Communication |
Subject:
Ophtalmology
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1. Nava CA, Velasco YLA. Nasolacrimal Duct Obstruction Review. JOJ Ophthal. 2017; 3(4): 555619. DOI: 10.19080/JOJO.2017.03.555619 [ Link] [ DOI] 2. Nemati S, Nasiri M, Medghalchi A, Rouhi R, Nasiri M. [Comparison of Endonasal Endoscopic versus External Dacryocystorhinostomy Results for Adult Patients with Acquired Nasolacrimal Duct Obstruction]. J Guil Uni Med Sci. 2014; 23(89): 66-74. [Article in Persian] [ View at Publisher] 3. Mito H, Takahashi Y, Nakano T, Asamoto K, Ikeda H, Kakizaki H. Consecutive microscopic anatomical characteristics of the lacrimal sac and nasolacrimal duct: cases with or without inflammation. Invest Ophthalmol Vis Sci. 2014 Jul; 55(8): 5233-37. DOI: 10.1167/iovs.14-14449 [ DOI] [ PubMed] 4. Maliborski A, Różycki R. Diagnostic imaging of the nasolacrimal drainage system. Part I. Radiological anatomy of lacrimal pathways. Physiology of tear secretion and tear outflow. Med Sci Monit. 2014 Apr; 20: 628-38. DOI: 10.12659/MSM.890098 [ DOI] [ PubMed] 5. Shams PN, Chen PG, Wormald PJ, Sloan B, Wilcsek G, McNab A, et al. Management of functional epiphora in patients with an anatomically patent dacryocystorhinostomy. JAMA Ophthalmol. 2014 Sep; 132(9): 1127-32. DOI: 10.1001/jamaophthalmol.2014.1093 [ DOI] [ PubMed] 6. Sung JY, Lee YH, Kim KN, Kang TS, Lee SB. Surgical outcomes of endoscopic dacryocystorhinostomy: analysis of age effect. Sci Rep. 2019 Dec; 9(1): 19861. DOI: 10.1038/s41598-019-56491-y [ DOI] [ PubMed] 7. Timlin HM, Kang S, Jiang K, Ezra DG. Recurrent epiphora after dacryocystorhinostomy surgery: Structural abnormalities identified with dacryocystography and long term outcomes of revision surgery: Success rates of further surgery following failed dacryocystorhinostomy surgery. BMC Ophthalmol. 2021 Mar; 21(1): 117. DOI: 10.1186/s12886-021-01869-8 [ DOI] [ PubMed] 8. Sobel RK, Aakalu VK, Wladis EJ, Bilyk JR, Yen MT, Mawn LA. A Comparison of Endonasal Dacryocystorhinostomy and External Dacryocystorhinostomy: A Report by the American Academy of Ophthalmology. Ophthalmology. 2019 Nov; 126(11): 1580-85. DOI: 10.1016/j.ophtha.2019.06.009 [ DOI] [ PubMed] 9. Saha R, Sinha A, Phukan JP. Endoscopic versus external approach dacryocystorhinostomy: A comparative analysis. Niger Med J. 2013 May; 54(3): 165-69. DOI: 10.4103/0300-1652.114580 [ DOI] [ PubMed] 10. Kamal S, Ali MJ, Nair AG. Outcomes of endoscopic dacryocystorhinostomy: Experience of a fellowship trainee at a tertiary care center. Indian J Ophthalmol. 2016 Sep; 64(9): 648-53. DOI: 10.4103/0301-4738.194340 [ DOI] [ PubMed] 11. Yang JW, Oh HN. Success rate and complications of endonasal dacryocystorhinostomy with unciformectomy. Graefes Arch Clin Exp Ophthalmol. 2012 Oct; 250(10): 1509-13. DOI: 10.1007/s00417-012-1992-x [ DOI] [ PubMed] 12. Joshi RS, Deshpande AS. Success Rate of Conventional Dacryocystorhinostomy in Post-acute Dacryocystitis Compared to Endonasal Dacryocystorhinostomy in Acute Dacryocystitis. J Ophthalmic Vis Res. 2017 Jul-Sep; 12(3): 290-95. DOI: 10.4103/jovr.jovr_264_15 [ DOI] [ PubMed] 13. Lee MJ, Khwarg SI, Kim IH, Choi JH, Choi YJ, Kim N, Choung HK. Surgical outcomes of external dacryocystorhinostomy and risk factors for functional failure: a 10-year experience. Eye (Lond). 2017 May; 31(5): 691-97. DOI: 10.1038/eye.2016.308 [ DOI] [ PubMed] 14. Karim R, Ghabrial R, Lynch T, Tang B. A comparison of external and endoscopic endonasal dacryocystorhinostomy for acquired nasolacrimal duct obstruction. Clin Ophthalmol. 2011; 5: 979-89. DOI: 10.2147/OPTH.S19455 [ DOI] [ PubMed] 15. Nichlani SS, Jagade MV, Ganeshan A. A comparative study between endoscopic and external approach dacryocystorhinostomy. Bombay Hosp J. 2010; 52(2): 189-96. [ Link] 16. Moras K, Bhat M, Shreyas CS, Mendonca N, Pinto G. External dacryocystorhinostomy versus endoscopic dacryocystorhinostomy: A comparison. J Clin Diagn Res. 2011 Apr; 5(2): 182-86. DOI: 10.7860/JCDR/2011/.1237 [ Link] [ DOI] 17. Taban M, Jarullazada I, Mancini R, Hwang C, Goldberg RA. Facial asymmetry and nasal septal deviation in acquired nasolacrimal duct obstruction. Orbit. 2011 Oct; 30(5): 226-29. DOI: 10.3109/01676830.2011.584931 [ DOI] [ PubMed] 18. Shams PN, Selva D. Acute post-operative rhinosinusitis following endonasal dacryocystorhinostomy. Eye (Lond). 2013 Oct; 27(10): 1130-36. DOI: 10.1038/eye.2013.147 [ DOI] [ PubMed] |
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Eslami M, Abdi F, Akbari-Kamrani M, Gordiz A, Najafi F. Evaluation of Endoscopic Dacryocystorhinostomy Success Rate in Patients with Nasolacrimal Duct Obstruction (2015-18). J Gorgan Univ Med Sci 2022; 24 (3) :116-120 URL: http://goums.ac.ir/journal/article-1-4094-en.html
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