Role of silicone stenting in endoscopic dacryocystorhinostomy
Keywords:Endonasal dacryocystorhinostomy, Epiphora, Lacrimal stents
Background: Dacryocystorhinostomy (DCR) is a surgical procedure performed to relief nasolacrimal duct obstruction, which involves the creation of ostium at the lacrimal bone to form a shunt in the nasolacrimal pathway. Closure of the rhinostomy opening was considered a major factor for surgical failure. Use of silicone stent in endoscopic DCR to improve the success rate of the operation have been tried by many surgeons. In this study we assess the success rates of endoscopic DCR with and without silicone stents.
Methods: Prospective study includes 30 patients were operated in the Department of ENT, Misrata Medical Center, from April 2017 to March 2018. They underwent endonasal endoscopic DCR for primary acquired nasolacrimal duct obstruction. These patients were randomly divided in two groups: A and B with 15 patients in each group. The group A patients underwent endoscopic DCR with silicone stent and group B patients underwent endoscopic DCR without stent. The results were statistically analyzed by chi-square test.
Results: 30 patients were included in this study, their age ranged from 17 to 60 years, complaining of epiphora, 24 (80%) were females and 6 (20%) were males. The success rate was higher in patients with silicone stent (93.33%) as compared to patients without silicone stent (86.67%) but this difference in the results is not statistically significant (As p value is 0.542 which is >0.05).
Conclusions: Endoscopic DCR is safe, successful procedure for treatment of nasolacrimal duct obstruction and there was no significant difference in the success rates of performing endonasal DCR with silicone or without silicone stents.
Caldwell GW. Two new operations for obstruction of the nasal duct, with preservation of the canaliculi, and with an incidental description of a new lacrimal probe. Am J Ophthalmol. 1893;10:189-93.
Mc Donogh M, Meiring JH. Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol. 1989;100:585-7.
Preechawai P. Results of non-endoscopic endonasal dacryocystorhinostomy. Clin Ophthalmol. 2012;6(1):1297-301.
Walker RA, Al-Ghoul A, Conlon MR. Comparison of non laser endoscopic endonasal dcr with external dcr. Can J Ophthalmol. 2011;46(2):192-5.
Lee DW, Chai CH, Loon SC. Primary external dcr versus primary endonasal dcr a review. Clin Experimental Ophthalmol. 2010;38(4):418-26.
Allen KM, Berlin AJ, Levine HL. Intranasal endoscopic analysis of DCR failure. Ophthal Plast Reconst Surg. 1988;4:143-5.
Lee KC. Out come of posterior lacrimal sac approach in endoscopic dcr: review of 35 cases. Am J rhinol. 2008;22:210-3.
Yang JW, Oh HN. Success rate and complications of endonasal dcr with unciformectomy. Graefes Arch Clin Exp Ophthalmol. 2012;250:1509-13.
Yigit O, Samancioglu M, Taskin U. External and endoscopic dacryocystorhinostomy in chronic dacryocystitis: comparison of results. Eur Arch Otorhinolaryngol. 2007;264:879-85.
Gibbs DC. New probe for the intubation of lacrimal canaliculi with silicone rubber tubing. Br J Ophthalmol. 1967;51:198.
Vishwakarma R, Sing N, Ghosh R. A study of 272 cases of Endoscopic Dacryocystorhinostomy. Ind J Otolaryngol Head Neck Surg. 2004;5(4):260-2.
Allen K, Berlin AJ. Dacryocystorhinostomy failure: association with nasolacrimal silicone intubation. Ophthalmic Surg. 1989;20(7):486-9.
Shah H, Sharma S, Suri N, Patel A. Comparison of surgical outcome in endoscopic Dacryocystorhinostomy with and without Silicone stent placement. National J Med Res. 2013;3(1):34.
Shashidhar K, Nagalotimath U, Dixit D. Endoscopic dacryocystorhinostomy with and without silicone stenting: A comparative study. Al Ameen J Med Sci. 2014;7:3.
Yadav R, Yadav DK, Rekha BP, Harvardan. A comparative study of endoscopic Dacryocystorhinostomy with and without Silicone stent. Int J Info Res Rev. 2017;4(3):3842-5.
Zilelioglu G. Results of endoscopic endonasal non- laser dacryocystorhinostomy. Documenta ophthalmologica. Adv Ophthalmol. 2002;105:57-62.
Jin HR, Yeon JY, Choi MY. Endoscopic dacryocystorhinostomy: creation of a large marsupialized lacrimal sac. J Korean Med Sci. 2006;21:719-23.
Unlu HH, Gunhan K, Baser EF, Songu M. Long-term results in endoscopic dacryocystorhinostomy: is intubation really required. Otolaryngol Head Neck Surg. 2009;140(4):589-95.
Kakkar V, Chugh J, Sachdeva S, Sharma N, Ramesh. Endoscopic dacryocystorhinostomy with and without silicone stent: a comparative study. Intl J Otolaryngol. 2008;9(1).