Comparison of surgical outcomes of endonasal dacryocystorhinostomy with or without mucosal flaps

Kansu, Leyla; Aydın, Erdinç; Avci, Suat; Kal, Alı; Gedik, Şansal

doi:10.1016/j.anl.2009.01.005

Cited by 58 publications

(58 citation statements)

References 15 publications

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“…Durvasula and Gatland reported that the formation of granulation tissue may be caused by the bare bone 25 . Kansu conducted a comparison study of surgical outcomes in EES-DCR with or without mucosal flaps and the results showed that the closure of bare bone with a nasal mucosal flap and an anastomosis between the lacrimal sac mucosa and the nasal mucosa decreased the formation of granulation tissue 3 . Mahendran introduced another option, like using a free mucosal flap to cover the bare bone in patients undergoing EES-DCR 26 .…”

Section: Discussionmentioning

confidence: 99%

“…Even though different methods to perform endonasal endoscopic surgery have been reported from 1990 to 1997, the success rate of the endonasal approach was unsatisfactory and not comparable with that of the external approach 3 . The most common cause of surgical failure in endonasal endoscopic DCR is that the neo-ostium is obstructed by either granulation tissue or synechia formed postoperatively 4, 5 .…”

Section: Introductionmentioning

confidence: 99%

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A Modified Preserved Nasal and Lacrimal Flap Technique in Endoscopic Dacryocystorhinostomy

Peng

Tan

Wang

et al. 2017

Sci Rep

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Here we describe a modified preserved nasal and lacrimal mucosal flap technique in endonasal endoscopic dacryocystorhinostomy (EES-DCR) for patients with epiphora secondary to primary acquired nasolacrimal duct obstruction (PANDO) and evaluate its outcomes. Twenty-five patients with PANDO were retrospectively reviewed. Modified preserved nasal and lacrimal mucosal flap technique in EES-DCR was applied in all 27 eyes of 25 patients. The patients were evaluated with objective (anatomical patency) and subjective (symptomatic cure) success rates within the duration of follow-up. In the present study, all of the patients’ surgical procedures were successful. There were 2 cases of flap dislocation from the rhinostomy site 1 week post-operation. After a mean follow-up of 4.9 ± 1.8 months, the success rate of anatomical patency was 100% (27/27) and the success rate of symptomatic cure was 92.6% (25/27). No significant complications occurred intraoperatively. We concluded that the modified preserved nasal and lacrimal mucosal flap technique in EES-DCR for treating PANDO is simple and safe, can effectively cover the bare bone around the opened sac, and provide a similar or even better clinical outcome compared with other routine treatment techniques used for this condition.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A Modified Preserved Nasal and Lacrimal Flap Technique in Endoscopic Dacryocystorhinostomy

Peng

Tan

Wang

et al. 2017

Sci Rep

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“…Similarly, some studies have reported acceptable success rates while preserving the mucosal flap in primary surgery. [2327]…”

Section: Discussionmentioning

confidence: 99%

Teamwork endoscopic endonasal surgery in failed external dacryocystorhinostomy

Yarmohammadi¹,

Ghasemi²,

Jafari³

et al. 2016

J Ophthalmic Vis Res

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Purpose:The purpose of this study was to evaluate the results of a teamwork revision endoscopic dacryocystorhinostomy (DCR) in eyes with previously failed external DCR.Methods:This retrospective study was performed on 50 failed external DCR subjects who underwent a teamwork revision endoscopic DCR by an ophthalmologist and an otolaryngologist. Paranasal sinus CT scanning was performed for each patient before the revision surgery. During surgery, any abnormal tissue noticed before silicone intubation was sent for pathological evaluation.Results:Endoscopic revision DCR was performed on 50 failed external DCR subjects with one-year follow-up. Of these, 31 were female (62%). The age range of the subjects was 18-88 years (mean: 59.98 years). Sinus CT showed at least one abnormality in 94% of cases. Revision endoscopy showed septal deviation (66%), scar formation (32%), ostium problems (28%), and sump syndrome (6%). Pathologic and clinical findings showed that chronic inflammation had a significant association with scar tissue and septal synechia (P = 0.001 and 0.008, respectively). At the final follow-up, anatomical and functional success was achieved in 45 out of 50 (90%) of subjects.Conclusion:Endoscopic revision DCR when performed as cooperation of otolaryngologists and ophthalmologists may help resolve the endonasal problems and increase the success rate.

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“…Historically, the outcomes of both external DCR and endonasal DCR have been improved through the formation of mucosal flaps. 7,[16][17][18] Occlusion of the ostium by granulation tissue or synechia is recognized as primary causes of DCR failure. 19,20 Mucosal flaps are believed to promote primary intention wound healing and creation of a 16,17 These studies have shown excellent functional and anatomical outcomes ranging from 89% to 91% to 95%, respectively.…”

Section: Discussionmentioning

confidence: 99%

“…7,[16][17][18] Occlusion of the ostium by granulation tissue or synechia is recognized as primary causes of DCR failure. 19,20 Mucosal flaps are believed to promote primary intention wound healing and creation of a 16,17 These studies have shown excellent functional and anatomical outcomes ranging from 89% to 91% to 95%, respectively. 5,21 While this study is too small to draw conclusions regarding the efficacy of mucosal flaps in endocanalicular laser DCR, it does demonstrate that the technique is feasible and merits further investigation.…”

Section: Discussionmentioning

confidence: 99%