An Easy Method for Intraoperative Confirmation of Lacrimal Sac Patency in Endoscopic Dacryocystorhinostomy

2016 ◽  
Vol 27 (3) ◽  
pp. 379-381
Author(s):  
Fabio Pagella ◽  
Alessandro Pusateri ◽  
Elina Matti ◽  
Paolo Carena ◽  
Luis Quiroa ◽  
...  
Keyword(s):  
Nasal Cavity ◽  
Saline Solution ◽  
Lacrimal Sac ◽  
Easy Method ◽  
Continuous Irrigation ◽  
Surgical Success ◽  
Endoscopic Dacryocystorhinostomy ◽  
Common Canaliculus ◽  
The Common

Purpose Few studies have focused on the intranasal localization of the lacrimal sac during endoscopic dacryocystorhinostomy: landmarks in order to find the medial wall of the lacrimal sac have been described, but there is a lack of description of methods for the verification of the complete marsupialization of the lacrimal sac during surgery. In this report, we propose an easy and effective method for certain intraoperative identification of lacrimal sac. Methods A method in order to verify the effective marsupialization of the lacrimal sac is applied and described: to ensure that the opening of the sac in the nasal cavity is complete, the surgeon should identify the Rosenmuller valve, which is the end of the common canaliculus in the lacrimal sac. Continuous irrigation with saline solution through the inferior canaliculus can be useful to obtain a clean surgical area and to permit easy intraoperative identification of the valve. Results Between 2007 and 2015, 193 endoscopic dacryocystorhinostomies were performed in our institutions. Postoperative surgical success at last follow-up (minimum 12 months) was 93.8% (181 out of 193 of cases). No major complications were observed. Conclusions Correct and complete exposure of the lacrimal sac during surgery is crucial for a good outcome: when the opening of the common canaliculus is identified, the surgeon is assured that the sac has been correctly and completely marsupialized inside the nasal cavity.

scholarly journals The Fibrin Glue Application Enhances Surgical Success Rate in Endonasal Endoscopic Dacryocystorhinostomy With Lacrimal Sac Preservation

2019 ◽  
pp. 014556131988212 ◽  
Author(s):  
Seyit Mehmet Ceylan ◽  
Ceren Erdoğan ◽  
Tevfik Sozen ◽  
Mahmut Alper Kanmaz ◽  
Ilyas Disikirik ◽  
...  
Keyword(s):  
Success Rate ◽  
Fibrin Glue ◽  
Complication Rate ◽  
Anastomosis Group ◽  
Lacrimal Sac ◽  
Endoscopic Endonasal ◽  
Subjective Report ◽  
Positive Functional ◽  
Surgical Success ◽  
Endoscopic Dacryocystorhinostomy

The purpose of this study to compare lacrimal sac flap preserving techniques with or without fibrin glue in patients undergoing endoscopic endonasal dacryocystorhinostomy. A retrospective study included 132 patients who underwent unilateral endonasal dacryocystorhinostomy between February 2011 and March 2016. Patients were divided into 2 groups: the nonfibrin glue group (n = 66) and fibrin glue anastomosis group (n = 66). Surgical success was defined as the patients’ subjective report of relief of epiphora and objective endoscopic confirmation of ostium patency confirmed by a positive functional dye test. These parameters were compared between the 2 groups. Both groups were similar, in terms of demographic and clinical characteristics. The surgical success rate was significantly higher in the fibrin glue anastomosis group (95.5%) than in the nonfibrin glue group (84.8%; P = .041). Complication rate was 6.1% in the nonfibrin glue group, whereas in the fibrin glue anastomosis group, it was 4.5%. The complication rate was similar in both groups ( P = .99). Creation of an anastomosis between the lacrimal sac flaps and the nasal mucosa using fibrin glue improves the outcome of endonasal endoscopic dacryocystorhinostomy.

Dacryocystorhinostomy

1986 ◽  
Vol 95 (4) ◽  
pp. 352-355 ◽  
Author(s):  
Mirko Tos ◽  
Viggo Balle ◽  
Rud Andersen
Keyword(s):  
Nasal Cavity ◽  
Late Results ◽  
Nasolacrimal Duct ◽  
Considerable Improvement ◽  
Lacrimal Sac ◽  
Routine Procedure ◽  
Observation Period

The extranasal method of dacryocystorhinostomy, which totally incorporates the lacrimal sac into the nasal cavity, is described, and the primary and late results of this method are presented in 57 patients with chronic epiphora caused by stenosis of the nasolacrimal duct. Immediately after the operation, the results were satisfactory in all patients. At late follow-up, with a median observation period of 5 years, 80% of the patients were completely free of epiphora and 15 % had periodic epiphora, which was a considerable improvement over the preoperative condition. The described method could become a rhinologic routine procedure in patients with chronic epiphora.

scholarly journals Anatomical and Functional Evaluation of Conventional vs Inferior Endoscopic Dacryocystorhinostomy in Study Cases of Idiopathic Chronic Dacryocystitis

2017 ◽  
Vol 10 (2) ◽  
pp. 86-90
Author(s):  
Aditya Kashyap ◽  
Satisg Negi ◽  
Prem L Chauhan ◽  
Kuldeep Thakur
Keyword(s):  
Operative Time ◽  
Nasal Endoscopy ◽  
Functional Evaluation ◽  
Lacrimal Sac ◽  
Endoscopic Dacryocystorhinostomy ◽  
Group I ◽  
Chronic Dacryocystitis ◽  
Endoscopic Dcr ◽  
Fluorescein Dye

ABSTRACT Objective To compare the results of conventional nasal endoscopic dacryocystorhinostomy (DCR) and inferior nasal endoscopic DCR in Study cases of idiopathic chronic dacryocystitis. Materials and methods Forty patients diagnosed with idiopathic chronic dacryocystitis were divided into two groups alternately. After relevant investigations, they were subjected for endoscopic DCR by two techniques. Twenty patients underwent conventional endoscopic DCR and 20 underwent inferior endoscopic DCR under transoral pterygopalatine block and topical lignocaine (4%) with adrenaline 1:2,000. After 3 months of follow-up in the outpatient department, nasal endoscopy along with fluorescein dye disappearance test (FDDT) at 10 minutes was done. Results Ninety-five percent (19/20) of patients undergoing conventional endoscopic DCR and 90% (18/20) of patients undergoing inferior endoscopic DCR were found to have patent anatomical fistula. On FDDT, nasal endoscopy after 10 minutes revealed 84% (16/19) in group I and 94.4% (17/18) in group II with fluorescein in nasal cavity. Conclusion Present study concludes the importance of bony, tendinous, and muscular support of lacrimal sac in physiological lacrimal pump functioning and advantage of relatively new technique of inferior endoscopic DCR. Inferior endoscopic DCR is associated with less operative time as well as less local complications. How to cite this article Thakur K, Kashyap A, Negi S, Chauhan PL. Anatomical and Functional Evaluation of Conventional vs Inferior Endoscopic Dacryocystorhinostomy in Study Cases of Idiopathic Chronic Dacryocystitis. Clin Rhinol An Int J 2017;10(2):86-90.

scholarly journals Reliable technique of Endoscopic Dacryocystorhinostomy – A Pilot Study

2016 ◽  
Vol 24 (3) ◽  
pp. 129-135
Author(s):  
Sudip Kumar Das ◽  
Chiranjib Das ◽  
Amit Bikram Maiti ◽  
Ruma Guha ◽  
Subhendu Chowdhury
Keyword(s):  
Pilot Study ◽  
Success Rates ◽  
Lacrimal Sac ◽  
Reliable Technique ◽  
Endoscopic Dacryocystorhinostomy ◽  
The Past ◽  
Canalicular Obstruction ◽  
External Dacryocystorhinostomy

Introduction Over last two decades endoscopic dacryocystorhinostomy has gained popularity over external dacryocystorhinostomy for post-canalicular obstruction. But the success rate is not very satisfactory. Our objective is to describe a technique where near 100% success can be achieved. Materials and Methods The study was conducted on 92 patients over 4 years and 6 months. The technique we describe involves creation of a large ostium, creation and apposition of nasal and lacrimal sac mucosal flaps. All the patients were under regular follow-up for12 months after operation. We also compared our result with other techniques. Results                                        The neo-ostium was well healed and free flow of normal saline was seen in 90 cases (97.83%) post-operatively. In one case there was ostium fibrosis and in another case granulations were seen. Conclusion For the past few decades many approaches have been tried for endoscopic dacryocystorhinostomy. But the long term success rates have not been satisfactory. Our technique of creating large stoma and proper mucosal apposition, when done properly gives near 100% success.

scholarly journals Endoscopic dacryocystorhinostomy with marsupialization of the lacrimal sac.

F1000Research ◽  
2019 ◽  
Vol 8 ◽  
pp. 259
Author(s):  
Erika Celis-Aguilar ◽  
Angel Castro-Urquizo ◽  
Lucero Escobar-Aispuro ◽  
José Alarid-Coronel ◽  
Nadia Villanueva-Ramos ◽  
...  
Keyword(s):  
Chart Review ◽  
Lacrimal Sac ◽  
Endoscopic Techniques ◽  
Endoscopic Dacryocystorhinostomy ◽  
Ocular Symptoms ◽  
Significant Difference ◽  
Different Types ◽  
Endoscopic Dcr ◽  
Clinical Chart

Objective: To analyze the efficacy of endoscopic dacryocystorhinostomy (DCR) with marsupialization of the lacrimal sac compared with other techniques of endoscopic dacryocystorhinostomy. Material and methods: Clinical chart review. Patients with lacrimal sac pathologies and endoscopic DCR with or without marsupialization of the lacrimal sac were included from 2011 to 2015. The outcome measurements were absence of ocular symptoms and permeability of the lacrimal sac. Results: A total of 24 patients were evaluated, 17 women and 7 men, average age was 47 years.  Seven patients underwent DCR with marsupialization, 17 patients underwent other endoscopic techniques. Average follow-up was 18 months. The efficacy (absence of symptoms and permeability of the lacrimal sac) of the DCR technique with marsupialization was 71%, without significant difference compared to other techniques (p = 0.686). Conclusion: Similar results were found in the different types of endoscopic DCR techniques. More studies are needed to corroborate our results.

Common canalicular obstruction secondary to the use of Herrick lacrimal plugs, requiring endoscopic dacryocystorhinostomy

2008 ◽  
Vol 123 (1) ◽  
pp. 129-130 ◽  
Author(s):  
L Dolan ◽  
C J MacEwen ◽  
P White
Keyword(s):  
Symptomatic Improvement ◽  
Endoscopic Dacryocystorhinostomy ◽  
Canalicular Obstruction ◽  
Common Canaliculus ◽  
The Common ◽  
Common Canalicular Obstruction

AbstractWe report the case of a 40-year-old woman who developed left common canalicular obstruction following insertion of a lacrimal plug. The patient underwent endoscopic dacryocystorhinostomy, revealing the presence of the lacrimal plug occluding the common canaliculus. The patient experienced symptomatic improvement of her epiphora post-operatively.

Analysis of the etiological factors of relapse after endonasal endoscopic dacryocystorhinostomy

2021 ◽  
pp. 61-63
Author(s):  
E.L. At'kova ◽  
◽  
N.N. Krakhovetskiy ◽  
O.V. Zhukov ◽  
◽  
...  
Keyword(s):  
Case Reports ◽  
Drainage System ◽  
Diagnostic Methods ◽  
Etiological Factors ◽  
Lacrimal Drainage System ◽  
Endoscopic Dacryocystorhinostomy ◽  
Complete Obliteration ◽  
Common Canaliculus ◽  
The Common ◽  
Lacrimal Drainage

The aim of this work is to study the etiological factors of failures after endonasal endoscopic dacryocystorhinostomy (EEDCR). We retrospectively studied the case reports of 485 patients (521 cases) with a relapse after EEDCR performed for primary dacryocystitis. The obtained data allowed us to reveal that the largest number of cases of relapse after EEDCR was a consequence of partial or complete obliteration of dacryocystorhinostomy (DCR) ostium (278 cases), which amounted to 53.3% of all analyzed cases. In 127 cases, the reason of recurrence after EEDCR was stenosis or obliteration of the common canaliculus ostium (24.4%). In 116 cases (22.3%), relapse after EEDCR was caused by a combination of several etiological factors. Of these, in 86 cases, synechiae and granulation in the area of dacryostomy were revealed. The retrospective analysis carried out within the framework of this work, based on the study of the results of the applied diagnostic methods, including multislice computed tomography with contrast enhancement of lacrimal drainage system, made it possible to determine and systematize the etiological factors of the development of repeated obstruction of the lacrimal drainage system after EEDCR. Key words: relapse, dacryocystitis, DCR, common canaliculus ostium, DCR ostium, synechiae.

scholarly journals Endonasal dacryocystorhinostomy: evaluation of the anatomical and functional results

2020 ◽  
Vol 6 (3) ◽  
pp. 519
Author(s):  
Kanchan Tadke ◽  
Vaibhav Lahane ◽  
Akshay Sarode ◽  
Nitish .
Keyword(s):  
Functional Results ◽  
Strong Positive Correlation ◽  
Success Rates ◽  
Lacrimal Sac ◽  
Surgical Success ◽  
Variable Success ◽  
Endoscopic Dcr ◽  
Age Range ◽  
Anatomical Success

<p class="abstract"><strong>Background:</strong> Dacryocystorhinostomy is a novel surgical technique for NLD obstruction performed by external and endonasal approach. Both procedures have variable success rates and advantages or disadvantages. The objectives were to study functional and anatomic outcomes of endoscopic DCR and to assess degree of ostium shrinkage in postoperative period.</p><p class="abstract"><strong>Methods:</strong> Prospective study comprising 68 patients of NLD obstruction with 70 procedures performed during the period of October 2014 to October 2016. Various dimensions of bony neo-ostium were recorded intraoperatively and during 1st and 3rd month follow up. Mitomycin C was applied in 37 cases. Degree of ostium shrinkage and its correlation with surgical success was studied. Outcome of study was measured as functional and anatomical success.  </p><p class="abstract"><strong>Results:</strong> 68 patients in age range of 7 to 71 years. Mean intraoperative height and width were 12.0±2.08 mm and 5.17±0.82 mm respectively and intraoperative surface area of ostium was 62.77±17.27mm<sup>2</sup>. The study showed strong positive correlation between initial and final ostium size. The final ostium irrespective of its size, if patent does not result in recurrence of symptoms and can be considered as success. In the present study, functional and anatomical success was 97.14% and failure rate was 2.86%.</p><p><strong>Conclusions:</strong> Both functional and anatomical success require creation of patent neo-ostium, although the intraoperative size of ostium is not the deciding factor for final outcome. Complete exposure of lacrimal sac, adequate mucosal preservation, good marsupialization and mucosal apposition are the some of the crucial factors responsible for stable ostium patency and hence the surgical success.</p>

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