Tube Position and Culture in the Nasal Cavities of Patients Treated with Silicone Tube Intubation

Abstract

Purpose: To evaluate the relationship between the position and direction of a silicone tube in the nasal cavity after silicone tube intubation and clinical features. Methods: This study included 70 eyes of 52 patients who were diagnosed with nasolacrimal duct obstruction and had silicone intubation surgery. The position and direction of the silicone tube were compared after tube intubation and before extubation. An intranasal swap culture was performed before tube intubation, and the removed silicone tubes were cultured. Results: The length of the silicone tube decreased from 8.7 ± 3.1 mm after intubation to 7.3 ± 3.1 mm before extubation, and the direction of the tube moved backward in the nasal cavity (p < 0.05). The bacterial culture rate changed from 94.3% before intubation to 75.7% before extubation. The most common Gram-positive bacteria (both preoperative and postoperative) was coagulase-negative Staphylococcus aureus. The most common Gram-negative bacteria were converted from Klebsiella aerogenes to Stenotrophomonas maltophilia. The fungal culture rate changed from 7.1% to 51.4%, and the culture rate increased when the silicone tube direction was moved backward (p < 0.05). The length and direction of the silicone tubes were not correlated with clinical symptoms or changes in eyelid height. Conclusions: The length of the silicone tube in the nasal cavity decreased, and the tube tended to move in a posterior direction after silicone tube intubation. Considering the increase in the intra-nasal fungal culture rate, it is better to place the silicone tube in the anterior part of the nasal cavity from the inferior meatus. To clarify further the fungal infection and its clinical findings, a study of cultures with respect to location in the lacrimal system would be required.

Long-term Outcome and Predictors of Silicone Tube Intubation for Patients with Nasolacrimal Duct Obstruction

“…7,8 술기가 복잡하고 전신마취를 요 하는 눈물주머니코안연결술에 비해, 단독으로 시행되는 실 리콘관삽입술은 비점막을 보호한다는 수술 방법의 유용성 을 보이며 국소마취로 시술이 가능하고 수술 후 회복이 빨 라 전신 상태가 좋지 않은 환자에게도 시행 가능하다. [9][10][11] 선행 연구들에 따르면, 경미한 정도의 코눈물관막힘 환 자나 처음으로 실리콘관삽입술을 시행하는 환자에서 높은 수술 성공률을 보인다고 보고된 바 있으며, 12,13 수술 전 눈 물소관관류술 결과 및 코눈물관의 폐쇄 정도가 실리콘관삽 입술이 성공에 영향을 미치는 인자로 공통적으로 제시되었 다. 9,14,15…”