An update on endoscopic mechanical and powered dacryocystorhinostomy in acute dacryocystitis and lacrimal abscess

Chong, Kelvin; Abdulla, Haitham Abdulla Abdulghaffar; Ali, Mohammad Javed

doi:10.1016/j.aanat.2019.07.009

Cited by 24 publications

(31 citation statements)

References 26 publications

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“…The disadvantages of this approach include a longer time to resolution, prolonged and recurrent infections, stula formation, cutaneous scar formation, and risk of failure of subsequent surgery because of scarring, synechiae, and granulation tissue within the lacrimal sac. 2,6,7 Over the past decade, primary EnDCR for the treatment of AD has been reported as a safe procedure with reasonable outcomes. [3][4][5][6][7][8][9][10][11][13][14][15][16] EnDCR allows access to the lacrimal sac through noninfected tissue plane and provides continuous drainage of the lacrimal abscess into the nasal cavity.…”

Section: Discussionmentioning

confidence: 99%

“…Our results are consistent with previous studies, in which symptomatic pain relief was usually achieved very early within 1-3 days and complete resolution of symptom was achieved within 5-10days. 5,6,13,15 Wu et al 5 reported a shorter time to resolution after primary EnDCR compared to delayed ExDCR in AD patients. The mean times for pain relief and resolution of medial canthal swelling were 1.0 and 3.4 days in the EnDCR group.…”

Section: Discussionmentioning

confidence: 99%

“…2,5 Increased intraoperative bleeding has been reported in several studies, but usually not to the extent of interfering with the surgery. 3,4,6,8,16 Madge et al 4 reported mild to moderate bleeding in 28% of patients. In only one case, the procedure was complicated due to excessive bleeding, resulting in poor mucosal ap formation.…”

Section: Discussionmentioning

confidence: 99%

“…5 In addition, delayed ExDCR results in cutaneous scarring, disruption of the lacrimal pump and a risk of surgical failure because of synechiae and granulation tissue within the lacrimal sac. 2,6,7 Recently, endoscopic dacryocystorhinostomy (EnDCR) has emerged as a primary treatment option for AD with advantages including rapid resolution of in ammatory symptoms and potential economic bene ts from shorter hospital stay, shorter antibiotics course, and fewer procedures. 3,6,[8][9][10] Recent studies have reported reasonable outcomes of primary EnDCR in patients with AD.…”

Section: Introductionmentioning

confidence: 99%

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Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

Sung

Kim

Hwang

et al. 2021

Preprint

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Purpose: To evaluate the surgical outcomes of primary early endoscopic dacryocystorhinostomy (EnDCR) in acute dacryocystitis (AD) and to determine the optimal timing for surgery.Methods: A retrospective review of the medical records was performed on consecutive patients who underwent primary early EnDCR (within 1 week) for AD between May 2010 and June 2020 (AD group) and age- and gender-matched control group of NLDO patients who underwent EnDCR (non-AD group). The primary outcome measures were surgical outcomes at the final follow-up examination. The secondary outcome measure was clinical course of AD patients. Subgroup analysis was performed to determine the optimal timing of surgery by comparing outcomes of very early EnDCR (within 3 days) and those of early EnDCR (between 4 and 7 days).Results: Forty-one patients were included in the AD group and 82 patients in the non-AD group. The anatomical and functional success rates were 87.8% and 82.9% in the AD group, and 91.5% and 84.1% in the non-AD group, which were not significantly different between the two groups (p = 0.532 and p = 0.863). In the AD group, the mean times for pain relief and resolution of swelling after surgery were 2.4 and 6.5 days after surgery. In subgroup analysis according to the timing of surgery, the time for symptom resolution after diagnosis, the length of hospital stay, and the duration of antibiotics treatment were significantly shorter after very early EnDCR (all ps < 0.05), whereas the surgical outcomes were not different between the 2 groups (p = 1.000)Conclusions: Primary early EnDCR is a safe and effective procedure for the treatment of AD. In particular, very early EnDCR, performed within 3 days, leads to faster recovery and shortens the course of antibiotic treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

Sung

Kim

Hwang

et al. 2021

Preprint

View full text Add to dashboard Cite

show abstract

“…However, the limitations of the conventional treatments include prolonged and recurrent infections, adverse effects of the long-term use of systemic antibiotics, and cutaneous fistula formation [ 5 ]. In addition, delayed ExDCR results in cutaneous scarring, disruption of the lacrimal pump, and a risk of surgical failure because of synechiae and granulation tissue within the lacrimal sac [ 2 , 6 , 7 ]. Recently, endoscopic dacryocystorhinostomy (EnDCR) has emerged as a primary treatment option for AD, with advantages including rapid resolution of inflammatory symptoms and potential economic benefits from shorter hospital stays, shorter antibiotics course, and fewer procedures [ 3 , 6 , 8 , 9 , 10 ].…”

Section: Introductionmentioning

confidence: 99%

Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

Sung

Kim

Hwang

et al. 2021

JCM

View full text Add to dashboard Cite

Purpose: To evaluate the surgical outcomes of primary early endoscopic dacryocystorhinostomy (EnDCR) in acute dacryocystitis (AD) and to determine the optimal timing for surgery. Methods: A retrospective review of medical records was performed on consecutive patients who underwent primary early EnDCR (within 1 week) for AD between May 2010 and June 2020 (AD group) and an age- and gender-matched control group of NLDO patients who underwent EnDCR (non-AD group). The primary outcome measures were the surgical outcomes at the final follow-up examination. The secondary outcome measure was the clinical course of AD patients. Subgroup analysis was performed to determine the optimal timing of surgery by comparing the outcomes of very early EnDCR (within 3 days) and those of early EnDCR (between 4 and 7 days). Results: Forty-one patients were included in the AD group and 82 patients in the non-AD group. The anatomical and functional success rates were 87.8% and 82.9% in the AD group, and 91.5% and 84.1% in the non-AD group, which were not significantly different between the two groups (p = 0.532 and p = 0.863). In the AD group, the mean times for pain relief and resolution of swelling after surgery were 2.4 and 6.5 days after surgery, respectively. In the subgroup analysis according to the timing of surgery, the time for symptom resolution after diagnosis, the length of hospital stays, and the duration of antibiotic treatments were significantly shorter after very early EnDCR (all ps < 0.05), whereas the surgical outcomes were not different between the two groups (p = 1.000). Conclusions: Primary early EnDCR is a safe and effective procedure for the treatment of AD. In particular, very early EnDCR performed within 3 days leads to faster recovery and shortens the course of antibiotic treatment.

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Immediate Endoscopic Dacryocystorhinostomy in Patients With New Onset Acute Dacryocystitis

Zhou

et al. 2021

The Laryngoscope

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Objectives: To compare the results of immediate endoscopic dacryocystorhinostomy (En-DCR) and delayed En-DCR in the treatment of new-onset acute dacryocystitis (AD).Study Design: This report describes a prospective randomized controlled interventional case series. Methods: Between April 2009 and May 2019, 176 adults presenting at a tertiary eye care center with new-onset AD manifesting within the last 48 hours were randomized into two groups. Altogether, 160 patients (48 male, 112 female) were included in this study, with a median age of 52.8 years (range: 18-82). Patients in group A underwent urgent En-DCR, although those in group B underwent a delayed En-DCR after 2 to 5 days of systematic antibiotic treatment. Variables compared between these two groups included the time for resolution of acute external inflammation, free lacrimal passage reconstruction (LPR) success rates, and complication rates.Results: Postoperative data were collected from 86 patients in group A and 74 patients in group B. Patients that underwent immediate En-DCR exhibited a quicker resolution of acute inflammation (P < .05). Patients that underwent delayed surgery experienced compilations of acute inflammation, with 10 ultimately developing skin fistulization and 4 exhibiting orbital cellulitis before surgery. The success rate of LPR at 12 months after surgery was higher in group A (81/86 94.2%) relative to group B (62/74 83.8%; P < .05).Conclusions: Immediate En-DCR is associated with quicker disease resolution and a higher long-term success rate, although reducing the incidence of complications including skin fistulization and the spread of infection.

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An update on endoscopic mechanical and powered dacryocystorhinostomy in acute dacryocystitis and lacrimal abscess

Cited by 24 publications

References 26 publications

Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

Optimal Timing for Primary Early Endoscopic Dacryocystorhinostomy in Acute Dacryocystitis

Immediate Endoscopic Dacryocystorhinostomy in Patients With New Onset Acute Dacryocystitis

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