Surgical outcome and unusual complications of paediatric external dacryocystorhinostomy

Quaranta‐Leoni, Francesco M.; Verrilli, Sara; Leonardi, Antonella

doi:10.1080/01676830.2018.1501396

Cited by 10 publications

(5 citation statements)

References 26 publications

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“…The standard treatment for nasolacrimal duct obstruction includes external or endoscopic DCR. A skin incision near the lacrimal sac is required for the external approach, while a nasal endoscope is used for the endoscopic approach ( 17 , 18 ). In this case, the previous operation may have aggravated or caused a certain degree of lacrimal drainage malformation.…”

Section: Discussionmentioning

confidence: 99%

A case report of proboscis lateralis: emphasis on the reconstruction of the lacrimal drainage system

Wang,

Zhao,

Tang

et al. 2024

Transl Pediatr

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Background Proboscis lateralis (PL) is a rare congenital malformation of the craniofacial structure. On the basis of 34 reported cases, Boo-Chai developed the first classification system in 1985 based on commonly associated anomalies of the eyes, palate, and lips. Sinonasal deformity is the most prevalent systemic abnormality associated with PL, accounting for 87.9%, and concomitant ocular anomalies account for 44–70%. Case Description We report a case of PL in a 20-month-old female patient with a mass in the left medial canthal area, and ipsilateral symptomatic epiphora. The removal of the proboscis at 4 months without the reconstruction of the nasolacrimal duct resulted in secondary sequelae that lasted 16 months. A second operation by a multidisciplinary team released the pressure on the lacrimal sac and reconstructed the lacrimal system. External dacryocystorhinostomy (DCR) is performed through the original external incision aided by nasal endoscopic examination. The bony passage between the nasal cavity and the lacrimal sac was reconstructed, and nasal endoscopy revealed a wide opening in the nasal cavity of at least 6 mm. Follow ups ensured a patent nasal airway, without complications. Conclusions It is instructive to learn from this case that treatment plans for PL should consider associated ocular anomalies and lacrimal drainage reconstruction, following a comprehensive and multidisciplinary approach.

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Section: Discussionmentioning

confidence: 99%

A case report of proboscis lateralis: emphasis on the reconstruction of the lacrimal drainage system

Wang,

Zhao,

Tang

et al. 2024

Transl Pediatr

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“…This improvement can be attributed to the alleviation of NLDO-related symptoms, including epiphroa and eye irritation, as well as the restoration of visiual comfort.Similar ndings have been reported in previous studies, emphasizing the impact DCR surgery on patient satisfaction and well-being. [3,7,[18][19][20] However, no signi cant correlation was observed between the decrease in TM values and GBI scores. Sipkova et al emphasized that a potential weakness of the GBI questionnaire is that it is not speci c and that a negative score may not indicate a negative outcome from surgery, but may instead result from generally poor health or other diseases.…”

Section: Discussionmentioning

confidence: 99%

Evaluation of the relationship between tear meniscus changes and quality of life outcomes after external dacryocystorhinostomy

Doran,

Ayintap,

Aytogan

2024

Int Ophthalmol

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This study aims to investigate the effects of external dacryocystorhinostomy (DCR) surgery on tear meniscus parameters and assess its relationship with improvements in quality of life (QoL) in patients with nasolacrimal duct obstruction (NLDO). MethodsThis prospective study included 30 patients diagnosed with NLDO who underwent external DCR surgery.Tear meniscus (TM) parameters, including height, depth and area, were measured using anterior segment optical coherence tomography (OCT). Lacrimal symptom questionnaire (Lac-Q), Munk scores and Glasgow bene t inventories (GBI) were collected. Statistical analysis was performed to evaluate the correlation between tear meniscus changes and improvements in QoL. ResultsTM height, depth and area decreased from preoperative median measurements (0.09 mm 2 , 0.37 mm, 0.56 mm) to postoperative median measurements (0.03 mm 2 , 0.21 mm, 0.30 mm) (p < 0.001). Lacrimal symptom scores and Munk scores showed signi cant improvement at 3 months postoperatively (p < 0.001). The GBI scores also demonstrated a signi cant improvement, indicating a positive impact on the patients' QoL. (p < 0.001). A statistically signi cant correlation was found between the change in TM parameters and LacQ lacrimal symptom scores. ConclusionExternal DCR surgery leads to signi cant improvements in tear meniscus parameters and quality of life outcomes in patients with NLDO. The decreased in TM height and TM area indicates improved tear lm dynamics and decreased tear volume, which positively impact the patients' ocular comfort and overall well-being. This study highlights the importance of tear meniscus evaluation as a potential market for assessing the success of DCR surgery and its impact on patients' QoL.

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“…DCR is indicating for patients with complete obstruction of NLD and also in patients with intractable NLD stenosis that epiphora interfere with daily activity. [ 1 2 3 ] It is logical, cost-effective, and beneficial for patients to have a noninvasive and simpler procedure performed whenever possible.…”

Section: Discussionmentioning

confidence: 99%

“…Epiphora is a common disorder in ophthalmology practice and it could be a serious problem that can interfere with daily activities. Dacryocystorhinostomy (DCR) is the gold standard treatment for nasolacrimal duct obstruction (NLDO) with more than 90% success rate,[ 1 2 ] but it is an invasive procedure that has considerable risks and expenses. [ 2 3 ] Recently, there has been a trend toward the application of the less invasive procedures for treating NLDO problems, especially for patients who have not complete NLDO.…”

Section: Introductionmentioning

confidence: 99%

Efficacy of probing adjunctive with low-dose mitomycin-C irrigation for the treatment of epiphora in adults with nasolacrimal duct stenosis

Masoomian¹,

Eshraghi²,

Latifi³

et al. 2021

Taiwan Journal of Ophthalmology

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PURPOSE: The purpose of the study was to investigate the efficacy of adjunctive low-dose mitomycin-C (MMC) during successful lacrimal duct probing in adults with nasolacrimal ducts (NLDs) stenosis. MATERIALS AND METHODS: This is a prospective case–control study on patients with NLD stenosis who were randomized into two groups. All patients underwent probing without or with an application of MMC. Former group received 0.2 mg/ml MMC irrigation for 5 min. The main outcome measures were objective evaluation of patency with irrigation, as well as patients' subjective assessment of improvement. RESULTS: There were 73 eyes in 58 consecutive patients; patient mean age ranged from 19 to 78 years (mean 44 years). Female included larger group of patients (63%) and mean duration of the symptoms was 26.1 months (range, 2–120 months). After mean follow-up of 11 months (range, 9–14 months), 23 (60%) of the 38 eyes in the MMC groups and 8 (22%) of the 35 eyes in control group had complete response and remained symptom free. This difference was statistically significant ( P = 0.005). According to the patient's satisfaction, epiphora was partially improved in 6 (17%) eyes of control group and 4 (10%) eyes in MMC group. Application of MMC has a better outcome in patients with severe stenosis ( P = 0.007); patients who had symptoms more than 12 months ( P = 0.02) and patients with constant epiphora were compared with intermittent symptoms ( P = 0.001). No complications were detected during patients follow-up. CONCLUSION: This study suggests acceptable long-term results for probing adjunctive with MMC irrigation for adults with NLD stenosis that can be recommended as a simple and effective procedure for these patients.

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Surgical outcome and unusual complications of paediatric external dacryocystorhinostomy

Cited by 10 publications

References 26 publications

A case report of proboscis lateralis: emphasis on the reconstruction of the lacrimal drainage system

A case report of proboscis lateralis: emphasis on the reconstruction of the lacrimal drainage system

Evaluation of the relationship between tear meniscus changes and quality of life outcomes after external dacryocystorhinostomy

Efficacy of probing adjunctive with low-dose mitomycin-C irrigation for the treatment of epiphora in adults with nasolacrimal duct stenosis

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