A comparative study on outcome of endonasal dacryocystorhinostomy with and without silicone intubation-otorhinolaryngology
DOI:
https://doi.org/10.18203/issn.2454-5929.ijohns20241325Keywords:
NLD, DCR, DCG, Deviated nasal septumAbstract
Background: Epiphora or “tearing eye” is a functionally and socially, bothersome symptom. Dacryocystitis is an inflammatory condition of the nasolacrimal sac caused due to an obstruction within the nasolacrimal duct (NLD). Dacryocystitis can be classified as acute and chronic or acquired and congenital. Chronic dacryocystitis is almost always managed surgically. The present study was undertaken for comparative study of outcomes of endonasal Dacryocystorhinostomy (DCR) done with and without silicone intubation.
Methods: The 50 cases dacryocystitis were selected. The patients were divided in group A cases (with intubation) and group B controls (without intubation) randomly. A detailed history was taken followed by general physical and clinical otorhinolaryngological examination. Patients were evaluated with nasal endoscopy, DCG (Dacrocystogram), through which site of obstruction was located.
Results: In our study, Among the cases 18 subject presented with right dacryocystitis and 7 with left dacryocystitis. Similarly, among the controls, 20 subjects presented with right dacryocystitis and 5 presented with left dacryocystitis. According to modified Likert’s score, at the end of 6 months when a nasal endoscopy was done along with syringing 96% of the cases had patent rhinostomy while only 80% of the controls showed patency. Post operative epistaxis was evident in 6 cases and 4 controls.
Conclusions: Endonasal DCR with and without stenting, had more or less similar results, with equal post op complications. Though, with stenting, success rates were high as shown in our study.
References
Mohamad SH, Khan I, Shakeel M, Nandapalan V. Long-term results of endonasal dacryocystorhinostomy with and without stenting. Ann R Coll Surg Engl. 2013;95:196-9.
Linberg JV, McCormick SA. Primary acquired nasolacrimal duct obstruction. A clinicopathologic report and biopsy technique. Ophthalmology. 1986;1:55-1.
Groessl SA, Sires BS, Lemke BN. An anatomical basis for primary acquired nasolacrimal duct obstruction. Arch Ophthalmol. 1997;115:71-4.
Ali MJ, Paulsen F. Surfactant proteins: Role in lacrimal drainage disorders. Med Hypotheses. 2019;124:35-6.
Hinojosa-Azaola A, García-Castro A, Juárez-Flores A, Recillas-Gispert C. Clinical significance of ocular manifestations in granulomatosis with polyangiitis: association with sinonasal involvement and damage. Rheumatol Int. 2019;39(3):489-95.
Singh S, Ali MJ. Congenital Dacryocystocele: A Major Review. Ophthalmic Plast Reconstr Surg. 2019;35(4):309-17.
Sáenz González AF, Busquet I Duran N, Arámbulo O, Badal Alter JM. Chronic dacryocystitis caused by sarcoidosis. Arch Soc Esp Oftalmol (Engl Ed). 2019;94(4):188-91.
Chen L, Fu T, Gu H, Jie Y, Sun Z, Jiang D, et al. Trends in dacryocystitis in China: A STROBE-compliant article. Medicine (Baltimore). 2018;97(26):e11318.
Sagar P, Shankar R, Wadhwa V, Singh I, Khurana N. Primary tubercular dacryocystitis - a case report and review of 18 cases from the literature. Orbit. 2019;38(4):331-4.
Heichel J, Struck HG, Glien A. Diagnostics and treatment of lacrimal duct diseases: A structured patient-centred care concept. HNO. 2018;66(10):751-9.
Magomedov MM, Borisova OY, Bakharev AV, Lapchenko AA, Magomedova NM, Gadua NT. The multidisciplinary approach to the diagnostics and surgical treatment of the lacrimal passages. Vestn Otorinolaringol. 2018;83(3):88-93.
McGrath LA, Satchi K, McNab AA. Recognition and Management of Acute Dacryocystic Retention. Ophthalmic Plast Reconstr Surg. 2018;34(4):333-5.
Enright NJ, Brown SJ, Rouse HC, McNab AA, Hardy TG. Nasolacrimal Sac Diverticulum: A Case Series and Literature Review. Ophthalmic Plast Reconstr Surg. 2019;35(1):45-9.
Meireles MN, Viveiros MM, Meneghin RL, Galindo-Ferreiro A, Marques ME, Schellini SA. Dacryocystectomy as a treatment of chronic dacryocystitis in the elderly. Orbit. 2017;36(6):419-21.
Kumar S, Mishra AK, Sethi A, Mallick A, Maggon N, Sharma H, Gupta A. Comparing Outcomes of the Standard Technique of Endoscopic DCR with Its Modifications: A Retrospective Analysis. Otolaryngol Head Neck Surg. 2019;160(2):347-54.
Prakash M, Viswanatha B, Rasika R. Powered endoscopic endonasal dacryocystorhinostomy with mucosal flaps and trimming of anterior end of middle turbinate. Indian J Otolaryngol Head Neck Surg. 2015;67(4):333-7.
Kim DH, Kim SI, Jin HJ, Kim S, Hwang SH. The Clinical Efficacy of silicone stents for endoscopic dacryocystorhinostomy: a meta-analysis. Clin Exp Otorhinolaryngol. 2018;11(3):151-7.
Nitin T, Uddin S, Paul G. Endonasal Endoscopic Dacryocystorhinostomy with and Without Stents-A Comparative Study. Indian J Otolaryngol Head Neck Surg. 2022;74(2):1433-41.
Svati VM, Prajakta SG, Prasanna PM. Endonasal Dacryocystorhinostomy: Results with or Without Stenting. Cureus. 2023;15(1):e33470.
Ingale MH, Shinde VV, Kumar AS, Singh HR. Clinical assessment and follow up of post-operative outcomes in endonasal dacrocystorhinostomy: Our experience. Int J Otorhinolaryngol Head Neck Surg. 2018;4(5):1-4.
