Evaluation of Dacryocystorhinostomy Failure With Computed Tomography and Computed Tomographic Dacryocystography

Evaluation of dacryocystorhinostomy failure with computed tomographic dacryocystography

“…The results of our study with regards to inappropriate size of osteotomy window as an important cause of DCR failure and are in accordance with the previous studies by Herbert J. Glatt, A Gokcek et al, Jordan and McDonald and Welham and Wulc. 9,10,12,13 In our study out of 38 patients, the location of the osteotomy window was inappropriate in 31 patients (81.57%). Osteotomy window was located anterior to lacrimal sac in 28 patients (73.68%), inferior in 2 patients (5.26%), antero-superior in 1 patient (2.63%).…”

“…Several reasons of failure of DCR have been reported, including ostium problems such as small size and inappropriate position of osteotomy window, bone regrowth, variations in nasal cavity and paranasal sinuses (e.g., concha bullosa, ethmoidal bullae), lacrimal sac and canalicular problems, tumors, and inflammatory disease. 9,13,14,[16][17][18][19][20][21][22] In our study it was seen that out of the 38 patients, 34 patients (89.47%) had inappropriate size of osteotomy window. The antero-posterior diameter of the bony ostium ranged from 4mm to 15mm.…”

“…1 The failure of DCR is rare, occurring in less than 10% of cases in most of the series. 9 The management of unsuccessful DCR poses a therapeutic problem and Identifying the causes of failure may help the surgeon in planning the reoperation and makes it possible to exclude the causative factors before or during the operation. Several reasons of failure of DCR have been reported, including ostium problems such as small size and inappropriate position of osteotomy window, bone regrowth, variations in nasal cavity and paranasal sinuses (e.g., concha bullosa, ethmoidal bullae), lacrimal sac and canalicular problems, tumors, and inflammatory disease.…”

“…10 Herbert J. Glatt et al found in their study that out of five patients all of them reported problems with bony ostium and inappropriate size was found in one patient. 9 Jordan and McDonald reported that they attempted to avoid failure by creating a large ostium with an average diameter of 15 mm and removing enough bone between the medial wall of the lacrimal sac and the nose so that bone could not obstruct the passage.…”

“…9 • Faulty opening of the osteotomy into the anterior ethmoidal air cells or unrecognized concha bullosa, 10 The most common cause of dacryocystorhinostomy failure is problem with the bony ostium, found in over half of the cases. Ideal bony ostium is the one which ensures that no bone is left within 5mm of the common canaliculus and that measures at least 15mm in diameter.…”