Secondary acquired nasolacrimal duct obstruction after radioiodine therapy is a comparatively rare complication but it requires treatment at an early stage. The symptoms of secondary acquired nasolacrimal duct obstruction are tearing, eye redness, discharge at ocular surface, a mass growing at lacrimal sac site. The considered complication occurs after radioiodine therapy in dose of 150 mCi, the rate of occurrence is dose-dependent. There are no clinical guidelines for preventing this complication but there are reports of nasolacrimal duct preventive intubation and those about developing new drug agents that block an action of the protein that uptakes iodine in the nasolacrimal duct mucosa. For diagnosing, special diagnostic procedures and an ophthalmologist consultation are required. For the correction of this complication, conservative treatment (with low efficacy) and special surgical treatment are used, including nasolacrimal duct recanalization with different techniques and anastomosis between nasolacrimal duct and nasal cavity formation. In cases of early patient encounter, it is possible to use more functional and less invasive surgical techniques, in cases of late encounter, more invasive surgical techniques are used.

Introduction. Mitomycin-C is an alkylating antibiotic used to prevent excessive scar formation in the dacryostoma area after dacryocystorhinostomy. In vitro studies proved its inhibition effect on fibroblast growth in 0.2 mg/ml concentration. Up to date, clinical data on its efficacy remain contradictory. Aim. To evaluate the concentration of Mitomycin-C in nasal cavity and lacrimal sac mucosa after topical application and to determine the clinical efficacy of this procedure. Materials and methods. 30 patients with nasolacrimal duct obliteration underwent an endonasal endoscopic dacryocystorhinostomy. At the end of the surgery, at the osteotomy site, a sponge soaked in Mitomycin-C 0,2 mg/ml was applied for 3 minutes. Nasal mucosa biopsy was performed immediately after application, in 30 minutes, and at the 1st day after surgery. Biopsy material analysis of was performed by liquid chromatography - mass spectrometry. The surgical treatment efficacy was established according to proposed efficacy criteria. Results. The analysis of Mitomicyn-C concentrations established them to be: 626 ± 176 ng/g tissue immediately after application, 230 ± 61 ng/g tissue in 30 minutes after application. In 24 hours after surgery, there was no Mitomycin-C in the tissue. Surgical efficacy was 86.7%, recurrences were found in 13.3% of cases. Conclusion. Surgery clinical results coincide with those obtained by other researchers. But chemical investigation showed that Mitomycin-C tissue concentration was lower than that in previous in vitro studies.

Lacrimal scintigraphy, single photon emission computed tomography, combined with X-ray computed tomography, subjective tearing estimation in points, and health depending quality of life evaluation wre performed in all cases. Same tests were repeated in 3 months after surgery. Results. A positive outcome rate was 90 % in both groups. There were no complications in group 1. A single case of stent dislocation was recorded in group 2. conclusion. BDP is an effective procedure in dacryostenosis of the lacrimal pathways vertical part obliteration. This procedure helps to avoid complications associated with long stent retention. It is possible to get good functional results even at short term after BDP surgery, and there is a possibility for this procedure to be carried out in an outpatient setting.G Key words: lacrimal pathways; dacryostenosis; balloon dacryoplasty; nasolacrimal duct intubation.УДК 617.764.2

16Оригинальные статьи мОдифицирОванный спОсОб интубации дакриОстОмы при эндОскОпическОй эндОназальнОй дакриОцистОринОстОмии