Hostname: page-component-586b7cd67f-rcrh6 Total loading time: 0 Render date: 2024-11-24T06:28:06.110Z Has data issue: false hasContentIssue false

Efficacy of endonasal dacryocystorhinostomy, using ‘cold steel’ instruments without stenting, in treatment of distal nasolacrimal duct obstruction

Published online by Cambridge University Press:  28 February 2011

L Ananth
Affiliation:
Department of Otorhinolaryngology, Sri Siddhartha Medical College Hospital and Research Center, Siddhartha University, Tumkur, Karnataka, India
P Hosamani*
Affiliation:
Department of Otorhinolaryngology, Sri Siddhartha Medical College Hospital and Research Center, Siddhartha University, Tumkur, Karnataka, India
G Chary
Affiliation:
Department of Otorhinolaryngology, Sri Siddhartha Medical College Hospital and Research Center, Siddhartha University, Tumkur, Karnataka, India
*
Address for correspondence: Dr Pradeep Hosamani, C-5, 292, B D A Houses, 2nd Stage, 3rd Phase, Domlur, Bangalore 560071, Karnataka, India Fax: +91 8028374117 E-mail: [email protected]

Abstract

Objective:

To assess the efficacy of an endonasal dacryocystorhinostomy technique using conventional instruments, without the use of any adjunctive techniques.

Study design:

Prospective, non-randomised, cohort study.

Methods:

Patients diagnosed with nasolacrimal duct obstruction between January 2006 and December 2008 were included in the study. Seventy-eight endonasal dacryocystorhinostomies (primary or revision) were performed with conventional ‘cold steel’ instruments. The technique involved complete exposure and marsupialisation of the lacrimal sac. No adjunctive procedures were used. Success was defined as complete resolution of epiphora and a patent lacrimal system, evaluated by lacrimal irrigation and endoscopy, one year post-operatively.

Results:

Seventy-four of the 78 cases were symptom-free after a minimum follow up of 12 months, giving an overall success rate of 94.9 per cent. The success rates for primary and revision cases were 95.5 and 90.9 per cent, respectively.

Conclusion:

Meticulous surgical technique can ensure high success rates with the use of conventional cold steel instruments, without the use of adjunctive procedures, making endonasal dacryocystorhinostomy a cost-effective, reliable procedure.

Type
Main Articles
Copyright
Copyright © JLO (1984) Limited 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1Caldwell, GW. Two new operations for obstruction of the nasal duct, with preservation of canaliculi, and with an incidental description of a new lacrimal probe. Am J Ophthalmol 1893;10:189–93Google Scholar
2Toti, A. A new conservative method of dacryocystorhinostomy for chronic suppuration of lacrimal sac [in Italian]. Clin Mod (Firenza) 1904;10:385–7Google Scholar
3Steadman, GM. Transnasal dacryocystorhinostomy. Otolaryngol Clin North Am 1985;18:107–11CrossRefGoogle ScholarPubMed
4McDonogh, M, Meiring, JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol 1989;103:585–7CrossRefGoogle ScholarPubMed
5Wormald, PJ. Powered endoscopic dacryocystorhinostomy. Laryngoscope 2002;112:6972CrossRefGoogle ScholarPubMed
6Massaro, BM, Gonnering, RS, Harris, GJ. Endonasal laser dacryocystorhinostomy; a new approach to nasolacrimal duct obstruction. Arch Ophthalmol 1990;108:1172–6CrossRefGoogle ScholarPubMed
7Gonnering, RS, Lyon, DB, Fisher, JC. Endoscopic laser assisted lacrimal surgery. Am J Ophthalmol 1991;111:152–7CrossRefGoogle ScholarPubMed
8Zhou, W, Zhou, M, Li, Z, Wang, T. Endoscopic intranasal dacryocystorhinostomy in forty-five patients. Chin Med J (Engl) 1996;109:747–8Google ScholarPubMed
9Manerath, JM, Guichard, C, Kyadavongs, P. Endonasal dacryocystorhinostomy using endoscopic guidance. Personal experience (in French). J Fr Ophtalmol 1999;22:41–5Google Scholar
10Angrist, RC, Dortzbach, RK. Silicone intubation for partial and total nasolacrimal duct obstruction in adults. Ophthal Plast Reconstr Surg 1985;1:51–4CrossRefGoogle ScholarPubMed
11Apaydin, KC, Fisenk, F, Karayalcin, B, Akar, Y, Saka, O. Endoscopic transnasal dacryocystorhinostomy and bicanalicular silicone tube intubation. Ophthalmologica 2004;218:306–11CrossRefGoogle ScholarPubMed
12Zilelioglu, G, Ugurbas, SH, Anadolu, Y, Akiner, M, Akturk, T. Adjunctive use of mitomycin C on endoscopic lacrimal surgery. Br J Ophthalmol 1998;82:63–6Google ScholarPubMed
13Hartikainen, J, Antila, J, Varpula, M, Puukka, P, Seppa, H, Grenman, R. Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Laryngoscope 1998;108:1861–6CrossRefGoogle ScholarPubMed
14Whittet, HB, Shun-Shin, GA, Awdry, P. Functional endoscopic transnasal dacryocystorhinostomy. Eye 1993;7:545–9CrossRefGoogle ScholarPubMed
15Linberg, JV, Anderson, RL, Bumstead, RM, Barreras, R. Study of intranasal ostium in external dacryocystorhinostomy. Arch Ophthalmol 1982;100:1758–62CrossRefGoogle ScholarPubMed
16Eloy, PH, Bertrand, B, Martinez, M, Hoebeke, M, Watelet, JB, Jamart, J. Endonasal dacryocystorhinostomy: indications, technique and results. Rhinology 1995;33:229–33Google ScholarPubMed
17Hartikainen, J, Puukka, P, Seppa, H, Grenman, R. Prospective randomized comparison of external dacryocystorhinostomy and endonasal laser dacryocystorhinostomy. Ophthalmology 1998;105:1106–13CrossRefGoogle ScholarPubMed
18Wormald, PJ, Kew, J, Van Hasselt, A. Intranasal anatomy of the nasolacrimal sac in endoscopic dacryocystorhinostomy. Otolaryngol Head Neck Surg 2000;123:307–10CrossRefGoogle ScholarPubMed
19Cokkeser, Y, Evereklioglu, C, Er, H. Comparative external versus endoscopic dacryocystorhinostomy: results in 115 patients. Otolaryngol Head Neck Surg 2000;123:488–91CrossRefGoogle ScholarPubMed
20Onerci, M. Revision dacryocystorhinostomy. In: Kountakis, SE, Jacobs, JB, Gospath, J, eds. Revision Sinus Surgery. Berlin, Heidelberg: Springer-Verlag, 2008;235–44CrossRefGoogle Scholar
21Metson, R, Woog, JJ, Puliafito, CA. Endoscopic laser dacryocystorhinostomy. Laryngoscope 1993;104:269–74CrossRefGoogle Scholar
22Bartley, GB. Acquired lacrimal drainage obstruction: an etiologic classification system, case reports and review of the literature. Ophthal Plast Reconstr Surg 1992;8:237–49CrossRefGoogle ScholarPubMed
23Allen, K, Berlin, AJ. Dacryocystorhinostomy failure: association with nasolacrimal silicone intubation. Ophthalmic Surg 1989;20:486–9Google ScholarPubMed
24Vieira, GS, Xavier, ME. Results and complications of bicanalicular intubation in external dacryocystorhinostomy [in Portuguese]. Arq Bras Oftalmol 2008;71:529–33CrossRefGoogle ScholarPubMed
25Yigit, O, Uzun, H, Han, T, Cakir, BO. The effect of bicanalicular silicone tube implantation on the success rate of endoscopic dacryocystorhinostomy [in Turkish]. Kulak Burun Bogaz Ihtis Derg 2005;14:7982Google ScholarPubMed
26Brookes, JL, Oliver, JM. Endoscopic endonasal management of prolapsed silicone tubes after dacryocystorhinostomy. Ophthalmology 1999;106:2101–5CrossRefGoogle ScholarPubMed
27Liao, SL, Kao, SCS, Tseng, JHS, Chen, MS, Hou, PK. Results of intraoperative mitomycin C application after dacryocystorhinostomy. Br J Ophthalmol 2000;84:903–6CrossRefGoogle ScholarPubMed
28Jokinen, K, Karja, J. Endonasal dacryocystorhinostomy. Arch Otolaryngol 1974;100:41–4CrossRefGoogle ScholarPubMed
29Welham, R, Wulc, A. Management of unsuccessful lacrimal surgery. Br J Ophthalmol 1987;71:152–7CrossRefGoogle ScholarPubMed
30Tsirbas, A, Wormald, PJ. Mechanical endonasal dacryocystorhinostomy. Am J Ophthalmol 2003;135:7683CrossRefGoogle Scholar