Secondary haemorrhage after dacryocystorhinostomy

Tsirbas, Angelo; McNab, Alan A.

doi:10.1046/j.1442-9071.2000.00249.x

Cited by 23 publications

(13 citation statements)

References 16 publications

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“…This gives a rate of less than 3% which compares well with both previous endonasal studies 21 and external DCR studies. 22 There were no cases of orbital fat exposure or frontal sinusitis which can occur if the dissection is taken too posteriorly into the uncinate. 21 Damage to the orbital plate of the ethmoid (lamina papyracea) and frontonasal duct can occur if the dissection is taken too posterior.…”

Section: Resultsmentioning

confidence: 94%

Mechanical endonasal dacryocystorhinostomy with mucosal flaps

Tsirbas

Wormald²

2003

British Journal of Ophthalmology

161

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Aims: To describe and assess the efficacy of mechanical endonasal dacryocystorhinostomy (MENDCR). This is a new technique that involves creation of a large rhinostomy and mucosal flaps. The study involved a prospective nonrandomised interventional case series with short perioperative follow up. Method: A prospective series of 104 consecutive endonasal DCRs performed from January 1999 to December 2001 were entered into the study. Patients included in the study had nasolacrimal duct obstruction and had not had previous lacrimal surgery. The technique involved anastomosis of nasal mucosal and lacrimal sac flaps and a large bony ostium. Surgery was performed by two surgeons (AT/PJW). Follow up assessment included nasoendoscopy as well as symptom evaluation. Success was defined as anatomical patency with fluorescein flow on nasoendoscopy and patency to lacrimal syringing. The average follow up time was 9.7 months (range 2-28, SD 6.7 months). Results: There were 104 DCRs performed on 86 patients (30 male, 56 female). The average age of the patients was 59 years (range 3-89, SD 24.1 years). Common presentations were epiphora (77%) and/or mucocele (19%). Septoplasty (SMR) was required in 48 DCRs (46%) and 13 DCRs (12.5%) needed other endoscopic surgery in conjunction with the lacrimal surgery. The surgery was successful in 93 cases (89%). Of the 11 cases that were classified as a failure six patients was anatomically patent but still symptomatic and another two had preoperative canalicular problems. The anatomical patency with this new technique was thus 95% (99 of 104 DCRs). Conclusion: MENDCR involves creation of a large ostium and mucosal preservation for the construction of flaps. The anatomical success is 95% and is similar to external DCR and better then other endonasal approaches. The authors suggest that creation of a large ostium as well as mucosal flaps improves the efficacy of this endonasal technique.

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Section: Resultsmentioning

confidence: 94%

Mechanical endonasal dacryocystorhinostomy with mucosal flaps

Tsirbas

Wormald²

2003

British Journal of Ophthalmology

161

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“…1991; Hanna et al. 1998; Tsirbas & McNab 2002). A study conducted on 112 patients between the ages of 70 and 90 reported no serious complications following external DCR (Hurwitz et al.…”

Section: Discussionmentioning

confidence: 99%

“…Dacryocystorhinostomy on an outpatient basis is generally accepted as a safe procedure. Nausea and epistaxis were the most frequent complications that prompted patients to present to the hospital, and various studies have reported the incidence of such complications as 0.5-4.0% (Dresner et al 1991;Hanna et al 1998;Tsirbas & McNab 2002). A study conducted on 112 patients between the ages of 70 and 90 reported no serious complications following external DCR (Hurwitz et al 2000).…”

Section: Discussionmentioning

confidence: 99%

“…In our study, postoperative epistaxis requiring a nasal tamponade developed in one patient (2%). Several series reported secondary haemorrhage in 0.5-3.9% of DCR cases (Dresner et al 1991;Walland & Rose 1994a;Tarbet & Custer 1995;Tsirbas & McNab 2002). A nasal tampon can be used to prevent postoperative haemorrhage, especially in patients in whom excessive bleeding occurred during the surgery.…”

Section: Discussionmentioning

confidence: 99%

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Simultaneous bilateral external dacryocystorhinostomy

Yazıcı

Budak

2007

Acta Ophthalmologica Scandinavica

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ABSTRACT.Purpose: To assess the outcome and complications of simultaneous bilateral external dacryocystorhinostomy (DCR) surgery. Methods: The records of all patients who underwent bilateral external DCR in a single session between November 1999 and October 2005 were reviewed. Results: The study cohort comprised 59 patients (50 females, nine males; age range: 6-72 years; mean age: 49 years). Nasolacrimal duct obstruction was acquired primarily in 54 patients, congenitally in three and secondary to sinonasal surgery in two. Thirteen eyes of eight patients had a history of unsuccessful lacrimal surgery. The operation was performed under local anaesthesia plus sedation in 54 patients (92%). Total intraoperative haemorrhage varied from 3 mL to 200 mL (median: 17 mL; mean: 37 mL). Excessive intraoperative haemorrhage (¼ 100 mL) occurred in five patients (9%). Total duration of surgery varied between 70 and 140 min, with an average of 89 min. Postoperatively, early bleeding requiring intranasal tamponade developed in one patient (2%) and bilateral wound infection in one patient (2%). Surgical success rate was 95%. Mean follow-up time was 8.8 months (range: 3-38 months). Conclusion: This study supports that the simultaneous bilateral external DCR surgery may not adversely affect surgical success and complication rates.

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“…Various studies displayed 0.5-3.9% secondary hemorrhage in cases with DCR. 4,10,[14][15][16] In cases with excessive intraoperative bleeding, a nasal tampon may be used to avoid postoperative hemorrhage.…”

Section: Discussionmentioning

confidence: 99%