Effects of Nasopore Packing on Dacryocystorhinostomy

Abstract

PurposeTo investigate the effects of placement of the absorbable packing material Nasopore at the anastomosis site of newly formed mucosal flaps on postoperative re-bleeding, discomfort, and on the success rate of dacryocystorhinostomy (DCR).MethodsA review of the medical records of patients with primary acquired nasolacrimal duct obstruction that underwent external or endonasal DCR by a single surgeon was performed. The degree of re-bleeding, discomfort, and postoperative results, including anatomical success, functional success and postoperative nasal findings such as granulation, synechiae, and membrane formation were compared in patients whose anastomosis site was packed with either Nasopore or Merocel, a non-absorbable packing material.ResultsA total of 77 patients (101 eyes) were included. Of the 101 eyes, 30 were packed with Nasopore, while 71 were packed with Merocel. The Nasopore group showed significantly better results than the Merocel group in the degree of re-bleeding and the level of patient discomfort (p = 0.000, 0.039, respectively; Pearson's chi-square test), whereas there were no statistically significant differences between the two groups in postoperative anatomical and functional success (p > 0.05).ConclusionsNasopore significantly reduced postoperative nasal re-bleeding and patient discomfort during the early post-surgical period, but failed to show an effect on the postoperative anatomical and functional success of DCR.

Association of rhinostomy shape and surgical outcome after endoscopic endonasal dacryocystorhinostomy

“…Merocel is a polymer of hydroxylated polyvinyl acetate, a material containing cavities capable of absorbing fluid. However, it is known to cause pain and frequent bleeding upon removal, with an increased risk of adhesion formation [16,17,25]. The removal of Merocel and potential bleeding after EDCR may influence rhinostomy shape.…”

“…Surgical success or failure was assessed separately for anatomical and functional measures [17]. To assess anatomical success, nasal endoscopy was used to apply gentle lacrimal irrigation without regurgitation.…”

Aspiration of Nasopore nasal packing

“…These chemical properties give it a high compressive strength and also encourage moisture absorption and subsequent fragmentation 3. This importantly means that it does not require removal and may improve quality of life in the immediate postoperative phase 4.…”

“…This importantly means that it does not require removal and may improve quality of life in the immediate postoperative phase 4. Studies suggest it can reduce levels of pack associated discomfort 3. It does however rely solely on local adhesion through moisture contact to secure it in place, and there is no external thread that may be used to secure it or prevent it from becoming dislodged.…”

Pathologic features and expression of heat shock protein 47 in the nasal mucosa and lacrimal sac: does it influence the surgical outcome of endoscopic endonasal dacryocystorhinostomy?

“…Follow-up observations after DCR were conducted 1 week, 1 month, 3 months, and 6 months after surgery, and nasal endoscopy was conducted at each follow-up. During the final follow-up, which was conducted 6 months later, epiphora was assessed, and a Munk scale score lower than 1 point (little wiping of tears) was defined as success, while higher than 2 points (wiping tears two to four times a day) was classified as failure [9]. Histological characteristics of the nasal mucosa and lacrimal sac (inflammation, fibrosis, and squamous metaplasia) were compared with regard to HSP47 expression and surgical outcomes, and correlations were investigated.…”