Endoscopic revision of external dacryocystorhinostomy

Clinical and Experimental Otorhinolaryngology, 2009

Results. Of 60 eyes, the levels of obstruction were the common canaliculus in 14 eyes (23.3%), the lacrimal sac in 13 eyes (21.7%), the duct-sac junction in 13 eyes (21.7%) and the nasolacrimal duct (NLD) in 20 eyes (33.3%). The ductsac junction obstruction was treated most successfully (100%), followed by NLD obstruction (90%), common canaliculus obstruction (78.6%) and saccal obstruction (69.2%). Conclusion. In patients with lacrimal drainage system obstruction, preoperative evaluation of obstruction level using DCG may be helpful for predicting the surgical outcome of endoscopic DCR. The saccal obstruction may have a worse prognosis than the other obstruction levels.

Ophthalmic Plastic & Reconstructive Surgery, 2009

To present the results of external dacryocystorhinostomy (ext-DCR) for epiphora using strict outcome criteria and provide an accurate baseline and evidence from which to compare the results of endonasal dacryocystorhinostomy.

American journal of rhinology & allergy, 2017

To compare the causes of failure between external and endoscopic dacryocystorhinostomy (DCR) techniques for the treatment of lacrimal obstruction. A retrospective cohort study. The study population consisted of 53 consecutive patients who underwent revision endoscopic DCR from 2002 to 2013 for lacrimal duct obstruction. Identified causes of previous DCR failure were compared between patients whose initial surgery was performed through an external versus an endoscopic approach. Reasons for surgical failure after external (n = 21) versus endoscopic (n = 32) DCR included cicatricial closure of the internal lacrimal ostium (52.4 versus 53.1%; p = 0.96), inadequate removal of bone overlying the lacrimal sac (23.8 versus 9.4%; p = 0.15), sump syndrome (9.5 versus 9.4%; p = 0.99), and intranasal adhesions (65 versus 37.5%; p = 0.05). Adhesions that involved the middle turbinate were a particularly impactful cause of failure when the DCR was performed through an external versus the endoscop...

Indian Journal of Otolaryngology and Head & Neck Surgery, 2010

The objective of present study was to compare the results of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. It was a prospective non-randomized study. Forty consecutive patients having complaints of watering with complete naso lacrimal duct obstruction were selected for the study. Dacryocystography was done in all the cases. Selection of type of operation was left to the patient's choice. All patients had preoperative counseling and both the procedures were explained in detail with their advantages and disadvantages. Twenty patients underwent endonasal dacryocystorhinostomy and twenty had external dacryocystorhinostomy. Silicon intubation was done in all cases of endonasal dacryocystorhinostomy for three months after surgery. The final follow-up was done at 12 months after surgery. The patency of lacrimal passage was confirmed by syringing and patients were questioned about their symptoms. There was no significant difference in the results of both surgeries. The complication rate in both groups was almost equal. Thus we came to the conclusion that these two different dacryocystorhinostomy techniques are acceptable alternatives.

Romanian Journal of Rhinology, 2015

OBJECTIVE. The aim of the study was to evaluate the endoscopic dacryocystorhinostomy (DCR) with some particularities and its advantages over external DCR.MATERIAL AND METHODS. We evaluated 3 female patients (age range 35-84 years) diagnosed with chronic dacryocystitis - lacrimal sac abscess (2 cases) and lacrimal sac fistula (1 case). All patients presented a history of repeated episodes of acute dacryocystitis initially treated with broad spectrum antibiotics by the ophthalmologist. The evaluation protocol consisted in cranio-facial CT scan or MRI for the evaluation of the lacrimal sac and nasal structures, an ophthalmologic examination with the catheterization of the superior and inferior lacrimal punctum with a light probe to verify the permeability of the lacrimal pathway, and the Jones test with fluorescein to receive information about the common lacrimal path. Lacrimal syringing with regurgitation of fluid from the opposite punctum was the only criteria to decide the surgery. ...

Applied Medical Research, 2015

Dacryocystography produces an image of the lacrimal sac and nasolacrimal duct (NLD) and is especially helpful in patients with suspected anatomic abnormalities like (a) congenital anomalies such as lacrimal sac diverticula and (b) patients who have had prior trauma (or) surgical procedures. Initial conservative dilation of the NLD having failed, the ophthalmologists were left with no option but to perform the conventional dacryocystorhinostomy (DCR), which requires an external incision resulting in a facial scar and is a long and fairly complicated procedure, requiring the use of operating microscope or loupes. DCR) is a surgical procedure done to drain the lacrimal sac in instances of intrasaccular and postsacular obstruction. Endonasal endoscopic DCR is now being performed as a primary procedure or for revision of failed cases of external this year. In this study, the efficacy of this procedure as a day case procedure and results of patients undergoing surgery with the 3 month follow-up are assessed. The study comprises the analysis of 20 patients of epiphora or chronic dacryocystitis who underwent endonasal endoscopic DCR within a period of 1 year. Based on the results, we concluded that endoscopic DCR is a simple, safe and minimally invasive procedure as it is a direct approach to the sac. It can be performed as a day case procedure under local anesthesia and excellent results. There is no need of routine systemic uncinectomy in all cases. Cosmetically, it is acceptable as there is no external scar.

Introduction: Dacryocystorhinostomy (DCR) has been the standard procedure for acquired nasolacrimal duct obstruction. Lacrimal sac can be approached (1) Conventional External (Ex-DCR) or (2) Endoscopic (EN-DCR) Objective : To compare success rate , complication rate between the procedures Materials and Methods: Study design, prospective, interventional , clinical study was conducted in department of otorhinolaryngology in conjuction with ophthalmology,AMCH ,Duration of study : One year , from july 2011 to june 2012 , No. of cases : 60 cases(30 Endo-DCR,30 Ex-DCR) . Data were analysed by graphpad prism version 6.01 for Microsoft, Independent-sample t test &, chi square test with Yates correction was applied for comparison between groups , P value of <0.05 was considered stastically significant . Results and Observations : Total 60( 47 females,13 males) cases randomised into 30( 27females, 3males) endoscopic dcr, 30( 20females,10 males) external dcr, Mean age (32.367 )with range 18-55 yrs. in endoscopic dcr, Mean age (37.534 )with range 16-66 yrs. in external dcr. Present study shows success rate of 86.67% for En-DCR & 90% for Ex-DCR with P-value 0.557 CONCLUSION : The present study clearly shows that En-DCR is having results comparable EX-DCR ,

Journal of Otolaryngology-ENT Research

Endoscopic dacryocystorhinostomy (e-DCR) is a well-established surgical procedure with results that are equivalent to the classic open approach. Although the aim of surgery is to create a direct communication between the lacrimal sac and the lateral wall of the nose by drilling out the lacrimal bone, different endoscopic surgical techniques to the lacrimal sac are possible. However nowadays we do not have a surgical procedure classification system. In an effort to enhance scientific communication, we would like to propose a surgical classification system based on the different insertion modalities of the uncinate process (UP) on the lacrimal bone and on the anatomical variations that may eventually require additional surgical steps.

Acta otorhinolaryngologica Italica : organo ufficiale della Società italiana di otorinolaringologia e chirurgia cervico-facciale, 2005

Data are reported on a series of 52 endoscopic procedures of dacryocystorhinostomy, performed in the Department of Otorhinolaryngology of the Hospital of Varese, between May 1999 and February 2003. The study population comprised 42 patients (32 female, 10 male. mean age 57 and 51 years, respectively) with naso-lacrimal obstruction. In all cases, pre-operative diagnosis consisted in irrigation of the lacrimal pathways, confirmed on dacryocystography; in selected cases, an additional computed tomography examination was carried out. All procedures were performed under general anaesthesia and surgical times were recorded; mean time for primary dacryocystorhinostomy was 30 minutes. A silicone tube was inserted in all patients for a period of 3 months. The procedure was successful in 81% of primary dacryocystorhinostomy cases and in 75% of revision dacryocystorhinostomy cases. Personal clinical and surgical experience, focusing on surgical techniques used in dacryocystorhinostomy, is desc...

the egyptian journal of histology, 2021

Purpose: To correlate the clinical data to the histopathological characteristics of lacrimal sac and bone specimens in adult patients undergoing indicated external transcutaneous dacryocystorhinostomy surgery (DCR) for primary acquired nasolacrimal duct obstruction (PANDO) in order to determine the important clinical parameters that may necessitate selective lacrimal biopsy in certain situations.Methods: This is non-comparative, non-controlled descriptive case series study with histopathological correlation. Lacrimal sac and bone specimens for each case were collected during DCR from consecutive patients with PANDO presenting to the outpatient clinic of “Ain Shams University” hospitals, then sent for histopathological examination.Results: Fifty-one lacrimal specimens were obtained from a total of 49 consecutive patients who underwent external DCR for clinical PANDO at the time interval from March 2018 to March 2020 at “Department of Ophthalmology, Ain Shams University” operating the...