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مقاله
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Abstract
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Title:
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Endoscopic endonasal team work surgery by ophthalmologist and otolaryngologist in failed external dacriocystorhinostomy
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Author(s):
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Hassan Ghasemi, Mohammad Ebrahim Yarmohammadi , Pupak Izadi
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Presentation Type:
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Oral
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Subject:
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Ophthalmic Plastic and Reconstructive Surgery
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Others:
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Presenting Author:
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Name:
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Hassan Ghasemi Khorinia
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Affiliation :(optional)
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Shahed University
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E mail:
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ghasemi518@yahoo.com
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Phone:
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22842230-22842288
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Mobile:
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09121326140
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Purpose:
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External dacryocystorhinostomy (DCR) is the gold standard method for treatment of nasolacrimal duct obstruction (NLDO) with a failure rate of 4-13%. Endonasal endoscopic DCR with simultaneous cooperation of ophthalmologist and otolaryngologist may increase success and decrease complications rates.
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Methods:
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In this cross sectional study, 50 failed external DCR were considered for pathologic evaluation and revision endoscopic DCR by ophthalmologist and otolaryngologist simultaneously.
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Results:
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The patients were included of 31 female (62%) and 19 male (38%). Age ranges were 18-88 years (mean= 59.98 years). At least one sinus CT abnormality was found in 94% of cases. Revision endoscopy showed inferior remnants of sac or sump syndrome (70%), scar formation (32%), ostium problems (28%), and nasal septal deviation (22%). Pathologic and clinical findings showed that chronic inflammation had significant association with scar tissue (P=0.001) and septal synechia to lateral nasal wall (P=0.008). Success rate was 90%.
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Conclusion:
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Sump syndrome, scar formation and ostium problems were the most important causes of external DCR failure. The effects of various parameters on success and complications rates necessitate the simultaneous team work cooperation in endoscopic DCR revision cases. Endoscopic revision DCR by ophthalmologist and otolaryngologist helps better resolution of endonasal problems and therefore increase success rate.
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Attachment:
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