Dacriocistorrinostomia endoscópica

Abstract

Endonasal endoscopic dacryocystorhinostomy (EN-DCR)is now a well-established procedure to relieve nasolacrimal duct obstruction, becoming its domain for the ENT surgeons indispensable. Aim: The aim of the present study is to report the experience of the Otorhinolaryngology Department of the University of São Paulo Medical School in the management of the obstruction of the drainage of the nasolacrimal system by EN-DCR, comparing with the results in literature. Study design: clinical retrospective. Material and Method: We reviewed the medical records of 17 patients (17 eyes) that were submitted to EN-DCR between april 2001 and july 2004. We analysed: sex, age at the time of diagnosis, etiology, clinical findings, surgical technique, use of silicone tubes, follow-up and complications. Results: Eight men and nine women, the age range was from 29 to 79 years (mean 42.6413.1 years), mean follow-up time: 15 months, presented a lacrimal clinic with epiphora. Powered DCR was performed in 06 cases and YAG LASER in 01 patient. Silicone tubes were used in all cases and left in place mean 7.9 weeks. The surgical success rate was 82,3%. Conclusion: EN-DCR showed one safe technique, with advantages in relation to the external technique. So ophthalmologists and ENT physicians must work in harmony to offer more benefits to its patients.

Dacriocistorrinostomia endoscópica: nossa experiência e revisão de literatura

“…The endonasal approach was first described by Caldwell in 1893, but it was forgotten for decades due to the limited capacity to visualise and assess the sinonasal anatomy. The introduction of microscopes and endoscopic techniques, associated with the close relationship of the lacrimal system and the nasal cavity, made endonasal surgical treatment of lower lacrimal disorders very popular among otorhinolaryngologists (2,7,8) . Currently, endoscopic dacryocystorhinostomy is a well-established technique in the treatment of nasolacrimal duct and sac obstruction (8)(9)(10) , and it is essential for otorhinolaryngologists to master the technique.…”

“…Yang et al (17) 1998 150 90 Cokkeser et al (7) 2000 51 88,2 Sham et al (18) 2000 17 88 Araujo Filho et al (2) 2004 17 82,3 Küpper et al (6) 2004 32 79,12 Ben Simon et al (19) ligaments and structures of the medial corner of the orbit, thus maintaining the physiological mechanisms of the lacrimal pump (13)(14)(15) . According to Cokkeser, dacryocystorhinostomy is successful in 70% to 95% (7) of cases, depending on a number of factors.…”

“…However, dacryocystorhinostomy (DCR) started to be performed by ophthalmologists since the technique using the external route was described by Toti in 1904. The endonasal route then practically fell into disuse until Heermann (1958), Prades (1970) and Rouvier (1981) described the use of a microscope for endonasal surgery, and endoscopic DCR was only described in 1988 (1,2) . Partial or complete obstruction of the lacrimal system produces constant or intermittent tearing called epiphora.…”