Acquired fistula of the lacrimal sac and laisser-faire approach. Description of the natural history of acquired fistulas between the lacrimal sac and the skin occurring before planned endonasal dacryocystorhinostomy (DCR) and without any treatment of the fistula

Pison, Aurelie; Fau, J.-L.; Racy, E.; Fayet, B

doi:10.1016/j.jfo.2016.03.009

Cited by 7 publications

(8 citation statements)

References 7 publications

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“…We similarly found a significant increase in recurrent acute dacryocystitis in patients with a specific pathology in this study. An acquired lacrimal fistula may develop spontaneously after an abscess that develops due to acute dacryocystitis or once the abscess is evacuated by incision 14,15 . We believe that the increase in acute dacryocystitis with specific pathologies may have also increased the lacrimal fistula rate in our study.…”

Section: Discussionmentioning

confidence: 70%

“…An acquired lacrimal fistula may develop spontaneously after an abscess that develops due to acute dacryocystitis or once the abscess is evacuated by incision. 14,15 We believe that the increase in acute dacryocystitis with specific pathologies may have also increased the lacrimal fistula rate in our study. Besides, the presence of an ulcer in the LS area may indicate a locally invasive tumor or Wegener granulomatosis.…”

Section: Discussionmentioning

confidence: 73%

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An Algorithm Recommendation to Detect Specific Pathology of the Lacrimal Sac

Demirel¹,

Fırat

et al. 2021

Journal of Craniofacial Surgery

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We aimed to recommend an efficient algorithm to detect the presence of specific pathologies of the lacrimal sac (LS). The charts of 296 patients who had undergone LS biopsy were reviewed retrospectively. The age, gender, history, examination and radiological findings, sac appearance, and pathology results of the patients were recorded. The power of our data to predict the presence of potential specific pathology was identified by regression analysis. After the causality evaluation of the statistical results, an algorithm was created to differentiate specific LS pathologies from chronic dacryocystitis. Our algorithm was mainly formed by deciding on radiological examination and biopsy according to the risk scoring created by the examination findings. A specific LS pathology was observed in 11 (3.7%) patients. When we applied the recommended algorithm to cases with a suspicion of specific pathology and/or found to have a specific pathology, 36.4% of

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 73%

An Algorithm Recommendation to Detect Specific Pathology of the Lacrimal Sac

Demirel¹,

Fırat

et al. 2021

Journal of Craniofacial Surgery

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“…Skin fistulization in patients with AD often develops secondary to the delay or failure of treatment or in patients suffering from recurrent dacryocystitis following failed surgical repair 11 . Several prior reports have described En-DCR procedures performed in patients with AD who developed the skin fistulization of lacrimal abscesses despite antimicrobial therapy 3,9,15 . A study by Ali et al 16 revealed that 5.6% of patients with AD developed fistulae, 83.3% of these cases being secondary to spontaneous lacrimal abscess rupture and the remaining 16.7% being secondary to incision and drainage.…”

Section: Discussionmentioning

confidence: 99%

“…Traditional treatments for acquired fistulae include conservative methods, an incision along the fistula pathway with concomitant fistular tract excision, and a combination of DCR and fistulectomy 17 . In patients with AD, acquired lacrimal fistulae can quickly heal following En-DCR without needing intubation or fistulectomy, even when these fistulae were present for 4 months to 10 years 8,9 . Increased fluid egress through the nose during the En-DCR procedure may lead to the deprioritization of the narrow fistular tract so that it can close spontaneously following the cessation of fluid outflow.…”

Section: Discussionmentioning

confidence: 99%

“…In most studies performed to date, En-DCR is performed after the formation of a lacrimal abscess in patients with AD, 3–6 with some patients inevitably experiencing skin fistulization during the observation or treatment period before scheduled En-DCR, 7 and some patients presenting to the hospital with AD-related fistulae. Some researchers have focused on performing En-DCR procedures in patients with AD without fistula-specific interventions 8,9 . At the same time, others had suggested that simultaneous fistulectomy should be performed on patients with fistulae that have been present for 1+ months 10 .…”

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confidence: 99%

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The Effects of Silicone Tube Intubation During Endoscopic Dacryocystorhinostomy in Patients With Acute Dacryocystitis With Acquired Skin Fistulization

Bian,

Han,

et al. 2023

Journal of Craniofacial Surgery

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Objective: This study aimed to determine the silicone tube intubation requirement for endoscopic dacryocystorhinostomy (En-DCR) in patients with acute dacryocystitis (AD) with acquired skin fistulization. Methods: Between September 2012 and October 2020, patients with AD and acquired skin fistulization undergoing En-DCR at the Eye Hospital of Wenzhou Medical University were randomized into treatment groups in which silicone tube intubation was carried out or not (groups A and B, respectively). All patients with skin fistulae present for 1+ months at En-DCR underwent fistulectomy. Operative success was assessed at 12 months post En-DCR in both treatment groups. Multiple logistic analyses were performed to assess for influencing factors on surgical success. Results: This study evaluated 94 patients for whom complete postoperative data were available, including 45 in group A and 44 in group B. Overall, 15 patients underwent fistulectomy and En-DCR simultaneously (8 from group A; 7 from group B ). At 12-month follow-up, anatomic and functional success rates were higher for patients in group A (93.3%, 86.7%) relative to those in group B (77.3%, 68.2%) (P<0.05). Intranasal ostium obstruction caused lacrimal passage reconstruction failure in group A. In contrast, intranasal ostium and canalicular obstruction caused it in patients in group B. No significant variations in operation success rates across groups were seen when group B cases with canalicular obstruction were eliminated from the analyses (P=0.070, >0.05). Multiple logistic regression analysis showed operative success was significantly influenced by fistulectomy (OR: 1.641, P<0.05) and intubation (OR: −1.559, P<0.05). Conclusion: These findings imply that in patients with AD with skin fistulization undergoing En-DCR, intraoperative intubation is linked with a lower incidence of canalicular obstruction and positive outcomes. Accordingly, intraoperative intubation should be performed when operating on patients with AD with skin fistulization.

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Embryology of the Lacrimal Drainage System

Gupta

2020

Endoscopic Dacryocystorhinostomy

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Acquired fistula of the lacrimal sac and laisser-faire approach. Description of the natural history of acquired fistulas between the lacrimal sac and the skin occurring before planned endonasal dacryocystorhinostomy (DCR) and without any treatment of the fistula

Cited by 7 publications

References 7 publications

An Algorithm Recommendation to Detect Specific Pathology of the Lacrimal Sac

An Algorithm Recommendation to Detect Specific Pathology of the Lacrimal Sac

The Effects of Silicone Tube Intubation During Endoscopic Dacryocystorhinostomy in Patients With Acute Dacryocystitis With Acquired Skin Fistulization

Embryology of the Lacrimal Drainage System

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