Comparative study of stenting and ostium packing in Endoscopic Dacryocystorhinostomy for Primary Acquired Nasolacrimal Duct Obstruction

Abstract

In this retrospective study, we compared the efficacy and safety of mechanical adjuvants in mucosalsparing, mechanical endoscopic dacryocystorhinostomy (MMeD) for primary acquired nasolacrimal duct obstruction (PANDO). 116 adult patients (90 female) aged 61 ± 11 received one of the following after MMED without topical mitomycin: no stenting or packing (group 1, n = 25), 1-week ostium packing by ribbon gauze (group 2, n = 29) or non-medicated absorbable gelatin sponge (group 3, n = 25), 8-week bicanalicular stenting (group 4, n = 28). 104 patients(92%) provided 12-month outcomes. Number of patients, age, gender, surgeon, and osteotomy size were comparable among groups (p = 0.4-0.9). Marginal significance was found in anatomical (group 1:80%, group 2:96.6%, group 3:96%, group 4:96.4%, p = 0.05) but not functional success (group 1:85%, group 2:85.7%, group 3:83.3%, group 4:88.9%, p = 0.75) at postoperative 12-month. Patients receiving any packing or stenting achieved better anatomical (96% versus 80%, p = 0.015) but not functional success (85% versus 86%, p = 0.90) compared to those receiving none. More patients receiving stenting developed postoperative granuloma than those who did not (87% versus 63%, p = 0.04). 1-week ostium packing was found to be as effective as 8-week bicanalicular intubation in improving anatomical outcome after MMED for PANDO. Functional outcome, however, did not differ among patients receiving mechanical adjuvant or not.

Endoscopic Dacryocystorhinostomy With Ologen Implant

“…The procedure was considered successful if the patient had grade 0 or grade 1 epiphora. Shams et al [8], and chin et al [9]. also used this scale.…”

A study of clinical profile of patients undergoing endonasal endoscopic dacryocystorhinostomy without stenting in a teaching hospital of Western Gujarat

“…Also, non-surgical factors including patient's age and ostium shape, the latter reflects the underlying lacrimal sac and ostium healing process, were associated with functional outcome, which is a more important endpoint than anatomical patency. 14 Out of 50 patients in our study, fluid from lacrimal sac of 23 patients was sent for culture and antibiotic sensitivity test. 10 samples were positive in culture.…”

A simple and efficient technique for suturing and knotting during endoscopic dacryocystorhinostomy

“…Furthermore, granulation tissue formation around the stent tubes is still a problem that is encountered during endoscopic procedure [ 13 ]. Routine intubation in endoscopic DCR is not necessary for patients with NLDO because no significant difference was found whether intubation was used [ 14 , 15 ]. Therefore, the appropriate surgery technique is vital for successful results, especially for mucosal edge-to-edge apposition.…”