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Endoscopic dacryocystorhinostomy in functional lacrimal obstruction

Published online by Cambridge University Press:  27 November 2007

C Brewis ,
M Yung ,
C Merkonidis  and
S Hardman-Lea
C Brewis
Affiliation:
Department of Otolaryngology, Ipswich Hospital NHS Trust, UK
M Yung*
Affiliation:
Department of Otolaryngology, Ipswich Hospital NHS Trust, UK
C Merkonidis
Affiliation:
Department of Otolaryngology, Ipswich Hospital NHS Trust, UK
S Hardman-Lea
Affiliation:
Department of Ophthalmology, Ipswich Hospital NHS Trust, UK
*
Address for correspondence: Mr Matthew Yung, Department of Otolaryngology, Ipswich Hospital NHS Trust, Heath Road, Ipswich IP4 5PD, UK. Fax: 00 44 1473 703576 E-mail: [email protected]
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Abstract

Introduction:

We performed endoscopic dacryocystorhinostomy in cases diagnosed with both anatomical and functional lacrimal obstruction, and here report results for the latter cases.

Methods:

Sixty-eight endoscopic dacryocystorhinostomies were performed for functional obstruction on 44 patients. The indication for surgery was epiphora in 66 patients and recurrent dacryocystitis in two. The minimum follow up was six months.

Results:

There was complete cure in 44 (65 per cent) patients, partial cure in nine (13 per cent) and no improvement in 15 (22 per cent). Revision surgery was performed in five of the 15 cases with no improvement, after which there was an overall complete cure in 47 patients (69 per cent), partial cure in 10 (15 per cent) and no improvement in 11 (16 per cent).

Discussion:

Endoscopic dacryocystorhinostomy is indicated in cases of epiphora with a diagnosis of functional lacrimal obstruction. Currently available investigations cannot reliably distinguish partial anatomical obstruction from pump failure.

Keywords

Lacrimal Duct ObstructionFunctionalPhysiologicalDacryocystorhinostomy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 122 , Issue 9 , September 2008 , pp. 921 - 923
Copyright
Copyright © JLO (1984) Limited 2007

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References

1 Paulsen, F. The human nasolacrimal ducts. Adv Anat Embryol Cell Biol 2003;170:1–106CrossRefGoogle ScholarPubMed
2 Rosenstock, T, Hurwitz, JJ. Functional obstruction of the lacrimal drainage passages. Can J Ophthalmol 1982;17:249–55Google ScholarPubMed
3 Cuthbertson, FM, Webber, S. Assessment of functional nasolacrimal obstruction – a survey of ophthalmologists in the southwest. Eye 2004;18:20–3CrossRefGoogle ScholarPubMed
4 Sprekelsen, MB, Barberan, MT. Endoscopic dacryocystorhinostomy: surgical technique and results. Laryngoscope 1996;106:187–9CrossRefGoogle ScholarPubMed
5 Yung, MW, Hardman-Lea, S. Endoscopic inferior dacryocystorhinostomy. Clin Otolaryngol 1998;23:152–7CrossRefGoogle ScholarPubMed
6 Conway, ST. Evaluation and management of ‘functional’ nasolacrimal blockage: results of a survey of the American Society of Ophthalmic Plastic and Reconstructive Surgery. Ophthal Plast Reconstr Surg 1994;10:185–7CrossRefGoogle ScholarPubMed
7 O'Donnell, B, Shah, R. Dacrocystorhinostomy for epiphora in the presence of a patent lacrimal system. Clin Exp Ophthalmol 2001;29:27–9CrossRefGoogle Scholar
8 Sahlin, S, Rose, GE. Lacrimal drainage capacity and symptomatic improvement after dacrocystorhinostomy in adults presenting with patent lacrimal drainage systems. Orbit 2001;20:173–9CrossRefGoogle Scholar
9 Delaney, YM, Khooshabeh, R. External dacrocystorhinostomy for the treatment of acquired partial nasolacrimal obstruction in adults. Br J Ophthalmol 2002;86:533–5CrossRefGoogle Scholar
10 Moore, WMH, Bentley, CR, Olver, J. Functional and anatomic results following two types of endoscopic endonasal dacrocystorhinostomy: surgical and Holmium laser. Ophthalmology 2002;109:1575–82CrossRefGoogle Scholar
11 Wormald, PJ, Tsirbas, A. Investigation and endoscopic treatment for functional and anatomical obstruction of the nasolacrimal duct system. Clin Otolaryngol 2004;29:352–6CrossRefGoogle ScholarPubMed
12 Yung, MW, Hardman-Lea, S. Analysis of the results of surgical endoscopic dacryocystorhinostomy: effect of the level of obstruction. Br J Ophthalmol 2002;86:792–4CrossRefGoogle ScholarPubMed
13 Smith, MG, Kong, AS, Yung, MW, Hardman-Lea, S, Leary, G. Lacrimal fossa block: an audit of a minimally invasive regional anaesthetic technique for endoscopic dacryocystorhinostomy (DCR). Clin Otolaryngol 2001;26:407–10CrossRefGoogle Scholar
14 The Royal College of Ophthalmologists. Quality Development Programme; Guidance for Clinical Governance in Ophthalmology. Royal College of Ophthalmologists, 1999, Available at: http://www.tripdatabase.com/spider.html?itemid=277743Google Scholar
15 Merkonidis, CM, Brewis, C, Yung, MW, Nussbaumer, M. Is routine biopsy of the lacrimal sac wall indicated at dacryocystorhinostomy? A prospective study and literature review. Br J Ophthalmol 2005;89:1589–91CrossRefGoogle ScholarPubMed