Nonsurgical fluoroscopically guided dacryocystoplasty of common canalicular obstructions

Wilhelm, Kai; Hofer, U; Textor, H. J.; Böker, Thorsten; Strunk, H.; Schild, Hans H.

doi:10.1007/s002709910001

Cited by 24 publications

(16 citation statements)

References 17 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Compared with the single-stent group, no significant complications appeared, which was consistent with previous reports [11][12][13][14][15]. The other treatment methods implicated for canalicular obstruction are DCR combined with membranectomy [5,6], trephination and silicone tube stenting [7,16], ballooning with/without silicone stenting [17,18], ballooning canaliculoplasty following lacrimal trephination [8], and intraoperative use of mitomycin C [9,10]. The success rates of these procedures vary in the range of 25-92% with the majority being under 50-60% (Table 7).…”

Section: Discussionsupporting

confidence: 86%

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Paik

Cho

Yang

2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

The purpose of the study was to evaluate the clinical effects of bicanalicular double silicone stents in endoscopic transnasal dacryocystorhinostomy with lacrimal trephinized canaliculoplasty for monocanalicular and common canalicular obstruction. Bicanalicular double silicone intubation in endoscopic transnasal dacryocystorhinostomy with lacrimal trephination was performed in 58 eyes of 54 patients (5 men, 49 women; mean age: 55.9 ± 14.9 years) with epiphora due to monocanalicular and common canalicular obstruction between November 2007 and August 2010. We reviewed the records of subjects who had undergone the same surgery with a bicanalicular single intubation for same disease between March 2004 and October 2007 as controls (56 eyes of 50 patients). We evaluated age, gender, the operative side, the site of canalicular obstruction, and the effects of double silicone intubation. Complications relating to the silicone tube were also investigated. The double-stent group showed higher anatomical success rates (91.4%) and functional success rates (82.8%) than the single-stent group (75.0 and 69.6%, respectively) (p = 0.034 and p = 0.103, respectively). Bicanalicular double silicone stenting in endoscopic transnasal dacryocystorhinostomy with lacrimal trephinized canaliculoplasty may be an effective treatment for monocanalicular and common canalicular obstructions. This may also reduce more invasive surgery including Jones tube insertion (p = 0.038).

show abstract

Section: Discussionsupporting

confidence: 86%

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Paik

Cho

Yang

2011

Eur Arch Otorhinolaryngol

View full text Add to dashboard Cite

show abstract

“…The feasibility and safety of balloon dacryocystoplasty (DCP) for treatment of obstructions of the lacrimal pathways in patients with epiphora has been described in several larger case series [1,2,3,4,5]. A disadvantage of this technique which is less invasive than operative dacryocystorhinostomy (DCR) is a relatively high rate of clinical failures and recurrences.…”

Section: Introductionmentioning

confidence: 99%

Clinical Effectiveness of Balloon Dacryocystoplasty in Circumscribed Obstructions of the Nasolacrimal Duct

Lüchtenberg

Bartel²,

Bink³

et al. 2007

Ophthalmologica

View full text Add to dashboard Cite

Purpose: Balloon dacryocystoplasty (DCP) is known to have limited clinical success rates. In a previous publication, we tried to define subgroups that could benefit from interventional treatment of tear duct stenoses. The purpose of this study was to evaluate the clinical effectiveness of DCP performed with limited indication confined to patients with circumscribed stenosis or distal occlusion of the nasolacrimal duct (NLD). Patients and Methods: Twenty-nine patients with severe epiphora due to dacryocystographically proven postsaccal obstruction of the lacrimal draining system were treated by means of DCP and were available for a telephone interview after a median follow-up period of 40 months (5–75 months). A standardized questionnaire covered the individual history of epiphora before and after interventional treatment. All patients had circumscribed stenoses of the lower lacrimal sac or the NLD or presented with short-distance occlusions of the distal NLD. Patients with canalicular, high saccal or diffuse lesions as well as cases with active dacryocystitis, suspicion of dacryocystolithiasis or posttraumatic stenosis were excluded from DCP. Failures or recurrences with no major improvement compared with the initial status were taken as a study endpoint. Results: We dilated 21 partial and 8 complete obstructions and post-DCP control dacryocystograms showed a widening of the ductal lumen or improvement of flow. In 25 out of 29 patients, regression of clinical symptoms occurred during the first week after treatment, 4 cases remained unchanged. Ten out of 25 patients with initial improvement reported recurrence of severe epiphora after a median period of 5 months. Five patients of all treated patients (n = 29) received additional operative dacryocystorhinostomy (DCR) after failure of DCP or due to severe recurrences. One patient received DCR during the 1st week after DCP (n = 1). Four out of 25 patients with initial improvement underwent DCR. Overall, 15 of the 29 treated patients had durable improvement of epiphora by DCP alone. Conclusion: Even patients with circumscribed obstructions of the NLD and exclusion of factors potentially associated with poor outcome of tear duct stenosis after DCP balloon dilatation showed a limited clinical success and high recurrence rate. The main argument to continue DCP as first or second line treatment in selected patients with duct obstructions is its lack of invasiveness. Even patients with increased risk of general anesthesia can be treated and approximately half of the operations may be avoided.

show abstract

“…bundene nasale Manipulation wurde -trotz der lokalen Anästhesie -von den Patienten in der Regel als unangenehm empfunden [33] und verlängerte die erforderliche Interventionszeit, so dass prinzipiell eine antegrade transkanalikuläre Vorgehensweise zu bevorzugen ist. Durch den Wegfall der nasalen Manipulation ließ sich die für die Intervention erforderliche Durchleuchtungszeit reduzieren [65]. Die klinischen Erfolgsraten von bis zu 85% [28,65] zeigen, dass die Offenheitsraten nach Durchführung der antegraden transkanalikulären Ballondilatation mit denen der retrograden transnasalen Vorgehensweise vergleichbar sind und insgesamt denen der chirurgischen Therapie entsprechen (Abbildung 5).…”

Section: Interventionelle Radiologische Therapieunclassified

“…Ohne zusätz-liche Bougierung und Lazerationen der Tränenkanäl-chen kann nachfolgend die Stenose mit einem 2,0-bis 2,5-mm-Ballon aufgedehnt werden. Unter Verwendung dieser Ballonkatheter lassen sich auch die Abflussbehinderungen im Bereich des Canaliculus communis mit einer der chirurgischen Therapie vergleichbaren klinischen Erfolgsrate von bis zu 85% behandeln [25,26,51,65].…”

Section: Therapie Kanalikulärer Tränenwegsobstruktionenunclassified

See 1 more Smart Citation

Interventionelle radiologische Therapie der Tr�nenwege

Lachmund

Wilhelm

Remonda

et al. 2005

Klinische Neuroradiologie

View full text Add to dashboard Cite

ZusammenfassungDer Augenpatient, in dessen Diagnostik und Therapie der Radiologe involviert ist, leidet gewöhnlich unter ständigem Tränenträufeln, der Epiphora. Die Epiphora ist ein häufiges Krankheitsbild und wird bei ca. 3% aller Patienten einer ophthalmologischen Praxis diagnostiziert. Epiphora ist entweder die Folge einer Überproduktion oder einer Abflussstörung von Tränenflüssigkeit infolge einer Obstruktion im Tränengangsystem. Epiphora wird am häufigsten durch Stenosen oder Verschlüsse des Tränengangsystems verursacht. Die Obstruktion ist meist im Bereich von Saccus und Ductus nasolacrimalis lokalisiert. Während in der Vergangenheit die Therapie ausschließlich operativ mittels Dakryozystorhinostomie erfolgte, wurden mittlerweile interventionelle radiologische Techniken entwickelt, die in bestimmten Fällen eine Alternative darstellen. Um die für den Patienten geeignetste Therapieform zu finden, müssen die genaue Ursache und Lokalisation der Epiphora abgeklärt werden. Hierbei stellt die in digitaler Subtraktionstechnik durchgeführte Dakryozystographie das bildgebende Standardverfahren dar. Im therapeutischen Bereich sind die interventionellen radiologischen Techniken der Dakryozystoplastie gegenüber den operativen Verfahren minimal invasiv, können ambulant und in Lokalanästhesie durchgeführt werden und erhalten die normale Anatomie des Tränenapparats. Zusätzlich kann eine störende Narbenbildung vermieden werden. Bei vergleichbaren technischen und klinischen Erfolgsraten stellt insbesondere die Ballondilatation bei Stenosen eine therapeutische Alternative zur Operation dar. Auch die Stentimplantation ist bereits jetzt eine wertvolle Therapieoption für die Behandlung von Tränenwegsverschlüssen. Die Stentimplantation ist besonders bei den Patienten indiziert, die einer operativen Therapie nicht zugänglich sind oder diese ablehnen. Schlüsselwörter: Tränenapparat · Epiphora · Dakryozystoplastie · Tränensack · Tränenwege · Ballondilatation · Stent-Implantation Klin Neuroradiol 2005;15:50-61 AbstractThe lacrimal system has become of interest to the radiologist, as radiologic interventions, requiring adequate diagnostic work-up, have been described. The eye doctor's patients, in whose diagnosis and treatment the radiologist may be involved, usually complain of constant tearing, epiphora. Epiphora is a common ophthalmologic problem, comprising 3% of clinical visits. It results from either overproduction or impaired drainage of lacrimal fluid, because of stenosis/obstructions of tear ducts. Severity of epiphora is graded clinically according to the scale of Munk et al., that takes the number of daily dabbings into account. Epiphora is mostly caused by stenosis or complete obstruction of the nasolacrimal duct system. The most common site of obstruction is the junction of the saccus and nasolacrimal duct. While in the past, treatment of this condition was surgical (e.g., by dacryocystorhinostomy), interventional procedures have been developed and have become well established for treatment in selected cases. To identify ...

show abstract

Nonsurgical fluoroscopically guided dacryocystoplasty of common canalicular obstructions

Cited by 24 publications

References 17 publications

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction

Clinical Effectiveness of Balloon Dacryocystoplasty in Circumscribed Obstructions of the Nasolacrimal Duct

Interventionelle radiologische Therapie der Tr�nenwege

Contact Info

Product

Resources

About