Abstract
Purpose
To evaluate the effects of uncinectomy for osteotomy method during endonasal dacryo- cystorhinostomy (DCR).
Methods
This retrospective review study comprised 102 nasolacrimal duct obstruction patients that underwent endonasal dacryocystorhinostomy with uncinectomy at our hospital between 2003 and 2006. The patients were classified into two groups based on records of preoperative endoscopic examination. Group A consisted of patients who had no nasal cavity abnormality, and Group B comprised patients who had a nasal cavity abnormality but received no treatment.
Results
Sixty-four patients were included in Group B. The success rates of endonasal DCR were 89.5% in Group A and 90.6% in Group B, with no statistically significant difference between the two groups ( p>0.99). There were no cases of mucosal burn, orbital fat prolapse, spinal fluid leak, maxillary sinusitis, or delayed bleeding.
References
1. Toti A. Nuovo metodo conservatore dicuraradicale delle sopourazioni croniche del saccolacrimale (dacriocistorhinostomia). Clin Moderna. 1904; 10:385–7.
2. Watkins LM, Janfaza P, Rubin PA. The evolution of endonasal dacryocystorhinostomy. Surv Ophthalmol. 2003; 48:73–84.
3. Rice DH. Endoscopic intranasal dacryocystorhinostomy results in four patients. Arch Otolaryngol Head Neck Surg. 1990; 116:1061.
4. Yoon JH, Kim KS. . Fontanelle and uncinate process in the lateral wall of the human nasal cavity. Laryngoscope. 2000; 110:281–5.
5. Yung MW, Logan BM. The anatomy of the lacrimal bone at the lateral wall of the nose: its significance to the lacrimal surgeon. Clin Otolaryngol. 1999; 24:262–5.
6. Wormald PJ, McDonogh M. The “swing‐ door” technique for uncinectomy in endoscopic sinus surgery. J Laryngol Otol. 1998; 112:547–51.
7. Caldwell GW. Two new operations for obstructions of the nasal duct with preservation of the canaliculi. Am J Ophthalmol. 1893; 10:189.
8. Mannor GE, Millman A. The prognostic value of preoperative dacryocystography in endoscopic intranasal dacryocystorhinostomy. Am J Ophthalmol. 1914; 12:659.
9. Lee HC, Chung WS. Success Rate of Endonasal Dacryocystorhinostomy. J Korean Ophthalmol Soc. 1992; 37:211–8.
10. Whittet HB. Shun-Shin GA, Awdry P. Functional endoscopic transnasal dacyocystorhinostomy. Eye. 1993; 7:545–9.
11. Hosemann W, Buhr W. Endoscopic endonasal dacryo- cystorhinostomy : results in 56 patients. Ann Otol Rhinol Laryngol. 1994; 103:363–7.
12. Javate RM, Campomanes BS Jr. . The endoscope on the radiofrequency unit in DCR surgery. Ophthal Plast Reconstr Surg. 1995; 11:54–8.
13. Cokkeser Y, Evereklioglu C, Er H. Comparative external versus endoscopic dacryocystorhinostomy:results in 115 patients. Otolaryngol Head Neck Surg. 2000; 123:488–91.
14. Dolman PJ. Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmology. 2003; 110:78–84.
15. Linberg JV, Anderson RL, Bumsted RM, Barreras R. Study of intranasal ostium external dacryocystorhinostomy. Arch Ophthalmol. 1982; 100:1758–62.
16. Jones LT. An anatomical approach to problems of the eyelids and lacrimal apparatus. Arch Ophthalmol. 1961; 66:111–24.
18. Chung ER, Lee KT, Choi WC. Success rate of endonasal dacryocystorhinostomy based on the location of the lacrimal sac. J Korean Ophthalmol Soc. 2002; 43:2000–4.
19. Lim IS, Jeong SK, Park YG. A study of factors related to surgical success rate of dacryocystorhinostomy. J Korean Ophthalmol Soc. 1997; 38:1322–7.
20. Hatt M. A concept and a method to prevent failures in lacrimal surgery. Ophthalmic Plast Reconstr Surg. 1987; 3:105–7.
21. Metson R. Endoscopic surgery for lacrimal obstruction. Otolaryngol Head Neck Surg. 1991; 104:473–9.
22. Park JD, Kim YI, Shin SG. The factors related to surgical success rate of endonasal dacryocystorhinostomy. J Korean Ophthalmol Soc. 1998; 39:2848–53.
23. Lee SJ, Na KS, Ji NC. A clinical study on the endonasal microdrill‐ assisted dacryocystorhinostomy. J Korean Ophthalmol Soc. 1998; 39:1620–1628.
24. Fayet B, Racy E, Assouline M. Systematic unciformectomy for a standardized endonasal dacryocystorhinostomy. Ophtalmology. 2002; 109:530–6.
25. Kim JM, Hong WP, Choi YJ, Kim SJ. The effect of nasal cavity abnormality related to surgical success rate of endonasal dacryocystorhinostomy. J Korean Ophthalmol Soc. 2006; 47:1233–7.
26. McDonogh M, Meiring JH. Endoscopic transnasal dacryo- cystorhinostomy. J Laryngol Otol. 1989; 103:585–7.
27. Yung MW, Hardman‐ Lea S.Endoscopic inferior dacryo- cystorhinostomy. Clin Otolaryngol Allied Sci. 1998; 23:152–7.
28. Welham RA, Wulc AE. Management of unsuccessful lacrimal surgery. Br J Ophthalmol. 1987; 71:152–7.
30. Fayet B, Racy E, Assouline M, Zerbib M. Surgical anatomy of the lacrimal fossa. Ophthalmology. 2005; 112:1119–28.
31. Steadman MG. Transnasal dacryocystorhinostomy Otolaryngol. Clin North Am. 1985; 18:107–11.
32. West JM. Eine Fensterresektion des Ductus naso‐ lacrimalis in Fa¨llen von Stenose. Arch Laryngol Rhinol. 1910; 24:62–4.
33. Menerath JM, Guichard C, Kydavongs P. Endonasal dacryocystorhinostomy using endoscopic guidance. Personal experience. J Fr Ophtalmol. 1999; 22:41–5.
34. Jouve Y, Dehon A, Blanc PH, Rouvier P. Dacryocystorhinostomy in endonasal microsurgery. Bull Mem Soc Fr Ophtalmol. 1983; 94:64–6.
35. Gutie´rrez-Ortega AR, Sprekelsen-Gasso C, Valles-San Leandro L, Delmperial JM. Endonasal dacryocystorhinostomy: first results. Orbit. 1995; 14:25–8.
36. Friedrich JP, Tritten JJ. Dacryocystorhinostomy by nasal endoscopy. an example of multidisciplinary collaboration. Rev Med Suisse Romande. 1998; 118:235–9.
37. el Khoury J, Rouvier P. Endonasal dacryocystorhinostomy (95 cases) s Acta. Otorhinolaryngol Belg. 1992; 46:401–4.
38. Chevalier E, Hazan A, Gerard B. . Dacryocystorhinostomie parvoie endonasale‐ endoscopique: technique chirurgicale et résultats àpropos dùne série de 24 cas. Rev Offic Soc Fr ORL. 1997; 44:37–45.
39. Sprekelsen MB. Barberán MT. Endoscopic dacryocystorhinostomy: surgical technique and results. Laryngoscope. 1996; 106:187–9.
40. Hartikainen J, Grenman R, Puukka P, Seppä H.Prospective randomized comparison of external dacryocystorhinostomy and endonasal laser dacryocystorhinostomy. Ophthalmology. 1998; 105:1106–13.
41. Rouviere P, Vaille G, Garcia C. . Dacryocystorhinostomy using the endonasal approach. Ann Otolaryngol Chir Cervicofac. 1981; 98:49–53.
42. Whittet HB. Shun-Shin GA, Awdry P. Functional endoscopic transnasal dacryocystorhinostomy. Eye. 1993; 7:545–9.
43. Fayet B, Racy E, Assouline M. Complications of standardized endonasal dacryocystorhinostomy with unciformectomy. Ophthalmology. 2004; 111:837–45.
Table 1.
Characteristics | |
---|---|
Age (years) | 48.5±12.8 |
Male : Female (eyes) | 12:90 |
Follow up (months) | 10.1±2.0 |
Intubation period (months) | 4.8±3.4 |
Table 2.
Number (eyes) | % | |
---|---|---|
Nasal septal deviation | 19 | 18.6 |
Agger nasi | 14 | 13.7 |
Middle turbinate hypertrophy | 21 | 20.6 |
Obtruding middle turbinate | 5 | 4.9 |
Prominent uncinate process | 5 | 4.9 |
Total | 64 | 62.7 |
Table 3.
Success | Failure | Total | |
---|---|---|---|
Group A | 34 (89.5%) | 4 (10.5%) | 38 |
Group B | 58 (90.6%) | 6 (9.4%) | 64 |
Total | 92 (90.2%) | 10 (9.8%) | 102 |