DOI: http://dx.doi.org/10.18203/issn.2454-5929.ijohns20173049

Combined endoscopic endonasal and subciliary approach in revision DCR cases

Manjunatharao S. V., Rajshekar M. M.

Abstract


Background: Study conducted to know surgical outcome of combined endoscopic endonasal and subciliary approach in revision DCR cases and complications associated with the procedure.

Methods: Prospective, single-blinded, randomized, interventional study is carried out in Tertiary level center from August 2009 to April 2016. Totally 18 patients (11 female and 7 male) were involved in the study who has undergone previous DCR (11 external DCR and 7 endoscopic DCR). The results were analyzed at end of the 3rd and 6th month both subjectively and objectively.  

Results: All the 18 patients who underwent combined approach were relived from epiphora. None of the patients developed any complications following surgery.

Conclusions: The combination of endoscopic and external approach gives benefits of the both approaches giving huge advantages in revision cases. It gives excellent visualization of the surgical field, ability to correct internal nasal pathologies, make clear rhinostoma, workprecisely on fibrosed lacrimal sac and nearly no external scar. It provides good team work opportunity between otorhinologist and ophthalmologist.


Keywords


Revision DCR, Epiphora, Nasolacrimal duct obstruction, Combined endonasal, Subciliary approach

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References


Agarwal S. Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction. J Laryngol Otol. 2009;123:1226–8.

Mohammad EY, Hassan G, Farhad J, Pupak I, Mohammadreza JN, Narges SC. Teamwork Endoscopic Endonasal Surgery in Failed External Dacryocystorhinostomy. J Ophthalmic Vis Res. 2016;11(3):282-6.

Sudip KD, Karabi B, Piyali S, Bijan B, Amit D, Soumen NB. Endoscopic Dacryocystorhinostomy: A Study at IPGMER, Kolkata. Indian J Otolaryngol Head Neck Surg. 2013;65(Suppl 2):366–70.

Jae WY, Ha NO. Success rate and complications of endonasal dacryocystorhinostomy with unciformectomy. Graefes Arch Clin Exp Ophthalmol. 2012;250:1509–13.

Kyung IW, Hyo SM, Yoon-duck K Characteristics of Intranasal Structures for Endonasal Dacryocystorhinostomy in Asians. Am J Ophthalmol. 2011;152 (3):491-8.

Herzallah I, Bassam A, Naif B, Osama M, Ameen A, Khalid A, et al. Endoscopic Dacryocystorhinostomy (DCR): a comparative study between powered and non-powered technique. J Otolaryngol Head and Neck Surg. 2015;44:56.

Ayoob M, Mahida K, Qurat-ul-ain, Dawood Z. Outcome and complications of endoscopic dacryocystorhinostomy without stenting. Pak J Med Sci. 2013;29(5):1236-9.

Ng DS, Chan E, Yu DK, Ko ST. Aesthetic assessment in periciliary “v-incision” versus conventional external dacryocystorhinostomy in Asians. Graefes Arch Clin Exp Ophthalmol. 2015;253:1783–90.

David MC, Iuri G, William RN, Taha ZS, Harold Lee HB. Improving outcomes by combining septoplasty with primary external dacryocystorhinostomy. Am J Otolaryngol Head Neck Med Surg. 2014;35:309–12.

Anasua G, Chetan V, Ritin G, Suryasnata R. Nonendoscopic endonasal dacryocystorhinostomy: Outcome in 134 eyes. Indian J Ophthalmol. 2016;64:211-5.

Rajesh RY, Ameya A, Girish S, Dhond. Combined subciliary and endoscopic dacryocystorhinostomy – a novel approach. Otolaryngol Online J. 2014;4(3).

Tsirbas A, Wormald PJ. Mechanical endonasal dacryocystorhinostomy with mucosal flaps. Br J Ophthalmol. 2003;87:43-7.

Shrestha, Kafl, Pokhrel, Maharjan, Toran. Successes rate of endoscopic dacryocystorhinostomy at KMC. Kathmandu University Med J. 2010;8(2):195-8.

Rajesh V, Singh N, Ratnadeep G. A study of 272 cases of endoscopic dacryocystorhinostomy. Indian J Otorhinolaryngol Head Neck Surg. 2004;56(4):259-61.

Sindwani R, Ralph BM. Endoscopic dacryocystorhinostomy. Operative Techniques Otolaryngol. 2008;19, 172-6.

Vijay RR, Vikram DD, Todd TK. Revision endoscopic dacryocystorhinostomy. Operative Techniques Otolaryngol. 2008;19:177-81.

Elina P, Grigori S, Juha S, Kai K, Henri T. Mitomycin C. In revision endoscopic dacryocystorhinostomy: A prospective randomized study. Am J Rhinol Allergy. 2011;25:425-8.

Jin HR, Yeon JY, Choi MY. Endoscopic dacryocystorhinostomy: Creation of a large marsupialized lacrimal SAC. J Korean Med Sci. 2006;21:719-23.

Saiju R, Morse LJ, Weinberg D, Shrestha MK, Ruit S. Prospective randomized comparison of external dacryocystorhinostomy with and without silicone intubation. Br J Ophthalmol. 2009;93:1220–2.

Gazmend K, Ilir B. External Dacryocystorhinostomy with and Without Suturing the Posterior Mucosal Flaps. Med Arh. 2014;68(1):54-6.