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Baek, Jang, Park, Jang, and Choi: Clinical Results of Nasopore Nasal Packing on Endonasal Dacryocystorhinostomy
Original Article

J Korean Ophthalmol Soc 2007;54(4):557-561.

Published online: 24 August 2007

DOI: https://doi.org/10.3341/jkos.2013.54.4.557

Clinical Results of Nasopore Nasal Packing on Endonasal Dacryocystorhinostomy

Ji Sun Baek, MD1, Sun Young Jang, MD2, Tae Seong Park, MD1, Jae Woo Jang, MD1, Hye Sun Choi, MD1,

1Department of Ophthalmology, Konyang University, Kim's Eye Hospital, Myung-Gok Eye Research Institute, Seoul, Korea

2Deartment of Ophthalmology, Soonchunhyang Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea

Address reprint requests to Hye Sun Choi, MD Department of Ophthalmology, Kim's Eye Hospital #136 Yeongsin-ro, Yeongdeungpo-gu, Seoul 150-902, Korea Tel: 82-2-2639-7811, Fax: 82-2-2639-3976, E-mail: hs0903@kimeye.com

Received 21 July 201218 September 2012       Accepted 21 January 2013

Copyright © 2007 Korean Ophthalmological Society

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

To investigate the effects of Nasopore as a nasal packing material on the surgical success rate and prevalence of postoperative complications after endonasal dacryocystorhinostomy (DCR).

Methods

The present study included a total of 558 patients (699 eyes) with primary acquired nasolacrimal duct obstruction who underwent endonasal DCR; 227 eyes were packed with Nasopore and 472 eyes were packed with Merocel. The surgical success rate and postoperative complications such as synechiae, granulation, wound healing (osteal mucosal epithelium epithelialization), postoperative bleeding, infection, and revision rate were compared between the packing materials. Results: The surgical success rate of the Nasopore group (99.1%, 98.6%) showed significantly better results than the Merocel group (97.2%, 95.1%) at postoperative 1 and 3 months (p = 0.04, 0.03 Pearson chi-square test), whereas there was no statistically significant difference between the 2 groups in postoperative surgical success rate at 1 week and 6 months. In comparison of postoperative complications, the Nasopore group (0%) showed a lower incidence of delayed wound healing (delayed epithelialization of osteal mucosal epithelium) than the Merocel group (2.3%; p = 0.013), whereas there was no difference in granulation, synechiae, postoperative bleeding, infection and revision rate (p > 0.05).

Conclusions

The Nasopore group showed a lower proportion of delayed wound healing and improvement of the surgical success rate at an early postoperative period after endonasal DCR compared to non-absorbable nasal packing material. J Korean Ophthalmol Soc 2013;54(4):557-561

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Keywords: Absorbable packing material, Dacryocystorhinostomy, Nasopore, Postoperative complication, Surgical success

References

1. Weber R, Keerl R, Hochapfel F, et al. Packing in endonasal surgery. Am J Otolaryngol. 2001; 22:306–20.
crossref
2. Fairbanks DN. Complications of nasal packing. Otolaryngol Head Neck Surg. 1986; 94:412–5.
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3. von Schoenberg M, Robinson P, Ryan R.Nasal packing after routine nasal surgery--is it justified? J Laryngol Otol. 1993; 107:902–5.
4. Weber R, Hochapfel F, Draf W. Packing and stents in endonasal surgery. Rhinology. 2000; 38:49–62.
5. Anderson RL. Gelfoam packing after dacryocystorhinostomy. Arch Ophthalmol. 1977; 95:520.
crossref
6. Basmak H, Cakli H, Sahin A, et al. Comparison of endocanalicular laser dacryocystorhinostomy with and without endonasal procedures. Graefes Arch Clin Exp Ophthalmol. 2011; 249:737–43.
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jkos-54-557f1.tif
Figure 1.
Representative photographs showing (A) delayed epithelialization of osteal mucosal epithelium at 2 months, (B) normally recovered epithelialization of osteal mucocal epithelium at 2 months, (C) fully recovered mucosal epithelialization at 6 months.
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jkos-54-557f2.tif
Figure 2.
Representative photographs showing tear meniscus height measured by slit-lamp examination and fluorescein staining. (A) Preoperative tear meniscus height, determined as 3 mm. (B) Tear meniscus height after tube removal, determined as 0.5 mm.
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Table 1.
Patient demographics & characteristics at baseline
Group 1 (Merocel®) n = 472 Group 2 (Nasopore®) n = 227 p-value
Age (years) 56.77 ± 10.1 55.04 ± 11.8 0.06*
Gender 0.06†
Male 98 (20.8%) 29 (12.8%)
Female 374 (79.2%) 198 (87.2%)
Side 0.36†
OD 235 (49.8%) 109 (48.0%)
OS 237 (50.2%) 118 (52.0%)
Previous dacryocystitis history 14 (3.0%) 10 (4.4%) 0.222†
Mean time to tube removal (week) 16.41 ± 4.68 15.35 ± 3.42 0.002*

* Independent t-test

† Chi-square test.

Table 2.
Comparision of postoperative general complications
Group 1 (Merocel®) n = 472 Group 2 (Nasopore®) n = 227 p-value
Delayed wound healing (Delayed epithelialization) 11 (2.3%) 0 (0%) 0.013*
Granuloma formation 146 (30.9%) 67 (30.3%) 0.64*
Synechiae 8 (1.7%) 5 (2.2%) 0.42*
Postoperative bleeding 4 (0.8%) 1 (0.4%) 0.48*
Postoperative infection 9 (1.9%) 6 (2.6%) 0.35*
Revision 9 (1.9%) 1 (0.4%) 0.11*

* Chi-square test.

Table 3.
Comparison of surgical success rate
Group 1 (Merocel®) n = 472 Group 2 (Nasopore®) n = 227 p-value
Postoperative 1 week 465/472 (98.5 %) 223/227 (98.2%) 0.87*
Postoperative 1 month 459/472 (97.2%) 225/227 (99.1%) 0.04*
Postoperative 3 months 443/466 (95.1%) 204/207 (98.6%) 0.03*
Postoperative 6 months 167/182 (91.8%) 34/41 (82.9%) 0.09*

* Chi-square test.

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