Transillumination-guided endoscopic endonasal dacryocystorhinostomy: Approach to revision cases and challenging anatomy

Vázquez, Alejandro; Blake, Danielle M.; Kanumuri, Vivek V.; Langer, Paul D.; Eloy, Jean Anderson

doi:10.1016/j.amjoto.2014.04.010

Cited by 3 publications

(2 citation statements)

References 6 publications

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“…Today, endoillumination is a widely used method for locating the lacrimal sac with different endoscopic techniques. 24 , 25 Many investigators claim that the axilla of the middle turbinate is a landmark for the roof of the lacrimal sac. 22 , 26 However, Wormald et al , 27 in an anatomic study with 47 patients, showed that the major part of the lacrimal sac (10 mm) is situated above the axilla of the middle turbinate and that it extends 1–2 mm below this landmark ( Fig.…”

Section: Key Points In the Success Of En-dcrmentioning

confidence: 99%

Endoscopic Dacryocystorhinostomy as Treatment for Lower Lacrimal Pathway Obstructions in Adults: Review Article

Penttilä

Смирнов²,

Tuomilehto

et al. 2015

Allergy�Rhinol (Providence)

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Obstruction of the lacrimal pathway is manifested by epiphora, infection, and blurred vision as well as ocular and facial pain. Conservative treatments only achieve temporary relief of symptoms, thus surgery is the treatment of choice. Dacryocystorhinostomy (DCR) is recognized as the most suitable treatment for patients with obstructions of the lacrimal system at the level of the sac or in the nasolacrimal duct. The aim of this operation is to create a bypass between the lacrimal sac and the nasal cavity. During the past 2 decades, advances in rigid endoscopic equipment and other instruments have made it possible to obtain more information about the anatomic landmarks of the nasolacrimal system, which led to the development of less-invasive and safer endoscopic techniques. However, many parts of the treatment process related to endoscopic endonasal dacryocystorhinostomy (EN-DCR) still remain controversial. This article reviews the published literature about the technical issues associated with the success of EN-DCR, and clarifies the pros and cons of different pre- and postoperative procedures in adults with lower lacrimal pathway obstructions.

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Section: Key Points In the Success Of En-dcrmentioning

confidence: 99%

Endoscopic Dacryocystorhinostomy as Treatment for Lower Lacrimal Pathway Obstructions in Adults: Review Article

Penttilä

Смирнов²,

Tuomilehto

et al. 2015

Allergy�Rhinol (Providence)

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“…Dacryocystorhinostomy (DCR) is a surgical procedure to create drainage between the lacrimal sac and the nasal cavity. 1,2 External DCR is the gold standard surgical method in the treatment of NLDO. It is cheap, the learning period is short, the success rate is high and doesn't require high technology instruments.…”

Section: Introductionmentioning

confidence: 99%

Compare Outcome in DCR with and without Silicon Tube Implantation

Bhat¹,

Raja²,

Ashraf³

2019

IJCMR

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Introduction: Dacryocystorhinostomy (DCR) is the most popular operation for treating nasolacrimal duct obstruction or chronic dacryostenosis. Study aimed to compare the success rate of external dacryocystorhinostomy with and without silicone intubation. Material and Methods: A total 223 were operated for nasolacrimal duct obstruction, at district hospital level. 70 patients were operated with silicon tube intubation and 153 patients operated without silicon tube. The patency of lacrimal drainage system was evaluated with lacrimal syringing. Age, gender, laterality, and lacrimal irrigation in the third month visit were recorded. Surgical success was accepted as the patency of the formed ostium with lacrimal syringing/ irrigation. Data was analysed using the average, standard deviation, variation coefficient, and the statistical significance was determined using t-test. Results: Success rate was higher 94.24% in patients with silicone tube intubation, and 86.92% in without silicon tube intubation, with p-value (p>0.05). Conclusion: Our findings suggest that success rate was higher in dacryocystorhinostomy with silicone intubation, although results were not statistically significant.

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Comparing the Success Rate of Dacryocystorhinostomy With and Without Silicone Intubation: A Trial Sequential Analysis of Randomized Control Trials

Xie

Zhang²,

Liu

et al. 2017

Sci Rep

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A previous meta-analysis reported no benefit for silicone intubation during dacryocystorhinostomy. However, the power of this meta-analysis was 0.274. Therefore, the benefit of silicone intubation remains controversial. We undertook a cumulative meta-analysis to evaluate the success rate of dacryocystorhinostomy (DCR) with and without the use of a stent. Pubmed, EMBASE and the Cochrane Library were searched. Statistical power and trial sequential analyses were performed according to the result of the meta-analysis. Twelve randomized controlled trials involving 969 cases met the inclusion criteria. The success rates of DCR with and without intubation were significantly different (p = 0.006). The success rates of external DCR (EX-DCR) with and without intubation were also significantly different based on subgroup analysis (p = 0.002). The cumulative z-curves crossed the O’Brian-Fleming boundaries. There were no significant differences in the success rate in the endonasal endoscopic DCR (EN-DCR) subgroup or the occurrence of postoperative complications between the two groups based on the meta-analysis, and the z-curve did not intersect any trial sequential analysis boundaries. DCR with intubation achieved better results than DCR without intubation, especially in the EX-DCR subgroup. Differences in the success rate in the EN-DCR subgroup and postoperative complications between the two groups were underpowered to reach a conclusion.

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Transillumination-guided endoscopic endonasal dacryocystorhinostomy: Approach to revision cases and challenging anatomy

Cited by 3 publications

References 6 publications

Endoscopic Dacryocystorhinostomy as Treatment for Lower Lacrimal Pathway Obstructions in Adults: Review Article

Endoscopic Dacryocystorhinostomy as Treatment for Lower Lacrimal Pathway Obstructions in Adults: Review Article

Compare Outcome in DCR with and without Silicon Tube Implantation

Comparing the Success Rate of Dacryocystorhinostomy With and Without Silicone Intubation: A Trial Sequential Analysis of Randomized Control Trials

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