Prognostic factors for outcome of endoscopic dacryocystorhinostomy in patients with primary acquired nasolacrimal duct obstruction

Mak, Shiu Ting; Io, Ida Yu-Fong; Wong, Albert Chak-ming

doi:10.1007/s00417-012-2228-9

Cited by 30 publications

(20 citation statements)

References 50 publications

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“…In our cohort, younger age was significantly associated with an increased failure rate of both primary and revision DCR. One earlier study evaluating outcomes after endo‐DCR for primary acquired nasolacrimal duct obstruction in 83 patients also showed younger age to be associated with failure ( p = 0.021) . The authors of that study postulated that younger patients had a relatively higher degree of fibrosis, which increased risk of failure .…”

Section: Discussionmentioning

confidence: 97%

“…There are several limitations to the current study, including the likelihood that some patients who developed recurrent symptoms after endo‐DCR sought help from other physicians, including revision endo‐DCR, or chose to forego a revision surgery altogether . Such patients would artificially increase our reported success rate for both primary and revision endo‐DCR.…”

Section: Discussionmentioning

confidence: 98%

“…One earlier study evaluating outcomes after endo-DCR for primary acquired nasolacrimal duct obstruction in 83 patients also showed younger age to be associated with failure (p = 0.021). 13 The authors of that study postulated that younger patients had a relatively higher degree of fibrosis, which increased risk of failure. 13 Another study demonstrated the overexpression of heat shock protein 47, a regulator of fibrosis, in nasal mucosa to be associated with endo-DCR failure (p = 0.009).…”

Section: Discussionmentioning

confidence: 99%

“…13 The authors of that study postulated that younger patients had a relatively higher degree of fibrosis, which increased risk of failure. 13 Another study demonstrated the overexpression of heat shock protein 47, a regulator of fibrosis, in nasal mucosa to be associated with endo-DCR failure (p = 0.009). 14 Investigations of other mucosal subsites have shown that advancing age is associated with decreased fibroblast counts and some fibroblast degeneration, 15 suggesting that advancing age could be associated with decreased fibrosis formation and, in turn, decreased postoperative scarring.…”

Section: Discussionmentioning

confidence: 99%

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Predictors of long‐term success and failure in primary and revision endoscopic dacryocystorhinostomy

Lehmann

Scangas

Jafari

et al. 2019

Int Forum Allergy Rhinol

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Background Although endoscopic dacryocystorhinostomy (endo‐DCR) is a common treatment of nasolacrimal duct obstruction, little is known about the determinants of surgical success and failure. The purpose of this study was to identify patient‐ and technique‐specific factors that may influence surgical outcomes of primary and revision endo‐DCR. Methods A retrospective review was conducted of 596 patients who underwent endo‐DCR over a 30‐year period (1989‐2018). Patients’ demographics and surgical techniques were assessed. Results Among the cohort of patients (n = 478) who underwent primary endo‐DCR, 10% (n = 48) required revision surgery. Patients who failed primary DCR tended to be younger (p = 0.015) and were less likely to have chronic sinonasal inflammation on histopathology (p = 0.047) than the successful surgery group. After adjusting for patient demographics and comorbidities, the occurrence of a postoperative complication was significantly associated with primary DCR failure (odds ratio [OR], 2.2; p = 0.032). Among the cohort of patients (n = 118) who underwent revision endo‐DCR, 8.5% (n = 10) required additional revision surgery. Patients who failed revision DCR tended to be younger (p = 0.022), more likely to have had intraoperative laser usage (p = 0.031), and more likely to have had an intraoperative complication (p = 0.013) than the successful revision surgery group. Endo‐DCR failure was not associated with smoking status, middle turbinate resection, or intraoperative visualization of the internal common punctum (p > 0.05). Conclusion An understanding of factors associated with primary and revision endo‐DCR failure can help to inform preoperative counseling, intraoperative surgical technique, and postoperative care in the treatment of patients with nasolacrimal duct obstruction.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 98%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 2 more Smart Citations

Predictors of long‐term success and failure in primary and revision endoscopic dacryocystorhinostomy

Lehmann

Scangas

Jafari

et al. 2019

Int Forum Allergy Rhinol

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show abstract

“…The use of lacrimal system endoscopy is also highly effective in identifying the anatomical location of nasal-lacrimal obstructions [29]. One group sought to determine the factors predicting EN-DCR failure or success [30]. One group sought to determine the factors predicting EN-DCR failure or success [30].…”

Section: Silicone Stentsmentioning

confidence: 99%

Evidence-based review of surgical practices in endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction and other new indications

Marcet

Kuk

Phelps

2014

Current Opinion in Ophthalmology

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Revision Dacryocystorhinostomy

Li¹

2019

Oculofacial, Orbital, and Lacrimal Surgery

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Prognostic factors for outcome of endoscopic dacryocystorhinostomy in patients with primary acquired nasolacrimal duct obstruction

Abstract: In endoscopic DCR for primary acquired nasolacrimal duct obstruction, younger patient age at time of surgery was associated with a higher rate of failure.

Cited by 30 publications

References 50 publications

Predictors of long‐term success and failure in primary and revision endoscopic dacryocystorhinostomy

Predictors of long‐term success and failure in primary and revision endoscopic dacryocystorhinostomy

Evidence-based review of surgical practices in endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction and other new indications

Revision Dacryocystorhinostomy

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