Revision results in recurrent chronic dacryocystitis who previously underwent external DCR or diode laser DCR

Year 2024, Volume: 2 Issue: 3, 109 - 112, 30.10.2024

Betül Dertsiz Kozan , Bahadır Utlu , Günay Kozan , Gönül Karataş Durusoy

https://doi.org/10.61845/agrimedical.1496700

Abstract

Aim: We aimed to evaluate our external dacryocystorhinostomy (DCR) results performed by the same surgeon using a silicone tube in patients with recurrent chronic dacryocystitis who had previously undergone external DCR or transcanalicular diode DCR and to compare them with the literature.
Material and Methods: Patients who underwent external DCR due to recurrent dacryocystitis between 2019-2022.They were divided into two groups. The first group who had previously undergone external DCR and the second group who had previously undergone transcanalicular diode laser DCR. Patients who were followed for at least 12 months in the postoperative period and who came to regular follow-up at 0, 1, 6 and 12 months were included in the study. At each examination, lavage was performed, and the passage was open. Its openness was considered as success.
Results: 40 eyes of 40 patients were included in the study. 28 of the patients were female (70%) and 12 were male (30%). The average follow-up period was 12±2 months. Nasolacrimal lavage was normal in 5 cases (25%) in the first group and 16 cases (80%) in the second group and surgical success was achieved. When the groups were compared among themselves, a statistically significant difference was found in terms of surgical success between the two groups (p<0,05).
Conclusion: The reason for the different success rates as a result of revision in DCR performed externally with diode laser is due to the better protection of the anatomical tissue after the first surgery with diode laser and less scar tissue.

Keywords

Revision DCR, External DCR, Diode laser DCR

Daha önce eksternal DSR veya diod lazer DSR yapılan nüks kronik dakriyosistitlerde revizyon sonuçları

Abstract

Amaç: Daha önce eksternal dakriosistorinostomi (DSR) veya transkanaliküler diod lazer DSR yapılan nüks kronik dakriosistitli hastalarda aynı cerrah tarafından silikon tüp kullanılarak yapılan eksternal DSR sonuçlarımızın değerlendirilmesi ve literatürle kıyaslanması amaçlanmıştır.
Gereç ve Yöntem: 2019-2022 yılları arasında nüks dakriosistit nedeniyle eksternal DSR yapılan hastalar incelendi. İki gruba ayrıldı. 1. grup daha önce eksternal DSR yapılan 2. grup daha önce transkanaliküler diod lazer DSR uygulanan olarak ayrıldı. Postoperatif dönemde en az 12 ay boyunca takip edilmiş olup 0., 1., 6. ve 12. ayda düzenli takibe gelen hastalar çalışmaya dahil edildi. Her kontrolde lavaj yapılarak pasajın açık olması başarı olarak kabul edildi.
Bulgular: Çalışmaya 40 hastanın 40 gözü dahil edildi. Hastaların 28’i kadın (%70), 12’si erkekti (%30). Takip süresi ortalama 12±2 ay idi. 1. grupta 5 olguda (%25), 2. grupta 16 olguda (%80) nazolakrimal lavaj açık olup cerrahi başarı elde edildi. Gruplar kendi aralarında karşılaştırıldığında her iki grup arasında cerrahi başarı açısından istatistiksel olarak anlamlı fark bulundu (p<0,05).
Sonuç: Diod lazer ile eksternal olarak yapılan DSR de revizyon sonucu başarı oranlarının farklı olmasının nedeni ilk cerrahi sonrası anatomik dokunun diod lazerle daha iyi korunmasına ve skar dokusunun az olmasına bağlıdır.

Keywords

Revizyon DSR, Eksternal DSR, Diod lazer DSR

References

• 1. Keerl R, Weber R. Dacryocystorhinostomy-state of the art, indications, results. Laryngorhinootologie. 2004;83(1):40-50.
• 2. Harish V, Benger RS. Origins of lacrimal surgery, and evolution of dacryocystorhinostomy to the present. Clin Exp Ophthalmol. 2014;42(3):284-7.
• 3. Busse H, Promesberger A, Promesberger H. Short and long-term results after external Dacryocystorhinostomy by Kaleff-Hollwich's method. Klin Monbl Augenheilkd. 1977;171(6):986-9.
• 4. Şimşek İ, Yabaş Kızıloğlu Ö, Ziylan Ş. External Dacryocystorhinostomy for the Treatment of Functional Nasolacrimal Drainage Obstruction. Turk J Ophthalmol. 2015;45(5):208-212.
• 5. Rajabi MT, Shahraki K, Nozare A, Moravej Z, Tavakolizadeh S, Salim RE, Hosseinzadeh F, Mohammadi S, Farahi A, Shahraki K. External versus Endoscopic Dacryocystorhinostomy for Primary Acquired Nasolacrimal Duct Obstruction. Middle East Afr J Ophthalmol. 2022;29(1):1-6.
• 6. Sobel RK, Aakalu VK, Wladis EJ, Bilyk JR, Yen MT, Mawn LA. A Comparison of Endonasal Dacryocystorhinostomy and External Dacryocystorhinostomy: A Report by the American Academy of Ophthalmology. Ophthalmology. 2019;126(11):1580-1585.
• 7. Lee DW, Chai CH, Loon SC. Primary external dacryocystorhinostomy versus primary endonasal dacryocystorhinostomy: a review. Clin Exp Ophthalmol. 2010;38(4):418-26.
• 8. Dolman PJ. Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology. 2003;110(1):78-84.
• 9. Sullivan L, Fearnley T, Al-Maskari A, El-Hindy N, Kalantzis G, Chang BY. External dacryocystorhinostomy in consultants and fellows - a comparison of the causes of failure. Hippokratia. 2015;19(3):216-8.
• 10. Kao SC, Liao CL, Tseng JH, Chen MS, Hou PK. Dacryocystorhinostomy with intraoperative mitomycin C. Ophthalmology. 1997;104(1):86-91.
• 11. Ghasemi H, Asghari Asl S, Yarmohammadi ME, Jafari F, Izadi P. External Dacryocystorhinostomy; Success Rate and Causes of Failure in Endoscopic and Pathologic Evaluations. Iran J Pathol. 2017;12(3):189-194.
• 12. El-Guindy A, Dorgham A, Ghoraba M. Endoscopic revision surgery for recurrent epiphora occurring after external dacryocystorhinostomy. Ann Otol Rhinol Laryngol. 2000;109(4):425–30.
• 13. Korkut AY, Teker AM, Ozsutcu M, Askiner O, Gedikli O. A comparison of endonasal with external dacryocystorhinostomy in revision cases. Eur Arch Otorhinolaryngol. 2011;268(3):377-81.
• 14. Tsirbas A, Davis G, Wormald PJ. Revision dacryocystorhinostomy: a comparison of endoscopic and external techniques. Am J Rhinol. 2005;19(3):322-5.
• 15. Onerci M. Dacryocystorhinostomy. Diagnosis and treatment of nasolacrimal canal obstructions. Rhinology. 2002;40(2):49-65.
• 16. Ari S, Kürşat Cingü A, Sahin A, Gün R, Kiniş V, Caça I. Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance. Int J Ophthalmol. 2012;5(2):238-41.
• 17. Sodhi PK, Pandey RM, Malik KP. Experience with bicanalicular intubation of the lacrimal drainage apparatus combined with conventional external dacryocystorhinostomy. J Craniomaxillofac Surg. 2003;31:187–190.
• 18. Orhan M, Şener C, Çakılkan S, Dayanır V, Bilgiç S. Silicone tube intubation with dacryocystorhinostomy in the lacrımal system obstructions. T. Klin J Ophthalmol. 1994;3:172–174.
• 19. Konuk O, Kurtulmusoglu M, Knatova Z, Unal M. Unsuccessful lacrimal surgery: causative factors and results of surgical management in a tertiary referral center. Ophthalmologica. 2010;224:361–366.
• 20. Van Swol JM, Myers WK, Nguyen SA, Eiseman AS. Revision dacryocystorhinostomy: systematic review and meta-analysis. Orbit. 2023;42(1):1-10.
• 21. Go Y, Park J, Kim K, Lee S. Comparison of nonlaser endoscopic endonasal revision surgery and diode laser transcanalicular revision surgery for failed dacryocystorhinostomy.J Craniofac Surg. 2015;26(3):863-6.
• 22. Sullivan L, Fearnley T, Al-Maskari A, El-Hindy N, Kalantzis G, Chang BY. External dacryocystorhinostomy in consultants and fellows-a comparison of the causes of failure. Hippokratia. 2015;19(3):216-8.
• 23. Evereklioglu C, Horozoglu F, Polat OA, Sonmez HK, Sener H, Arda H. Modified external revision- DCR in previous failed endonasal, transcanalicular or external-DCR: technical strategy and teaching Pearls for success. Rom J Ophthalmol. 2023;67(1):14-19.
• 24. Deosthale N, Garikapati P, Choudhary S, Khadakkar S, Deshpande A, Mangade S, Dhote K. Surgical Outcome of Endoscopic Dacryocystorhinostomy with and Without Prolene Stent in Chronic Dacryocystitis: A Randomized Controlled Trial. Indian J Otolaryngol Head Neck Surg. 2023;75(4):3443-3448.