Outcomes of Endoscopic Dacryocystorhinostomy in Patients Receiving Radioactive Iodine Therapy for Thyroid Carcinoma

Jin Heung Park; Su Kyung Jung; Ji Sun Paik; Suk Woo Yang

doi:10.3341/jkos.2014.55.3.333

Journal List > J Korean Ophthalmol Soc > v.55(3) > 1009901

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Park, Jung, Paik, and Yang: Outcomes of Endoscopic Dacryocystorhinostomy in Patients Receiving Radioactive Iodine Therapy for Thyroid Carcinoma

Original Article

J Korean Ophthalmol Soc 2014;55(3):333-336.

Published online: 7 September 2014

DOI: https://doi.org/10.3341/jkos.2014.55.3.333

Outcomes of Endoscopic Dacryocystorhinostomy in Patients Receiving Radioactive Iodine Therapy for Thyroid Carcinoma

Jin Heung Park, MD, Su Kyung Jung, MD, Ji Sun Paik, MD, Suk Woo Yang, MD, PhD

Department of Ophthalmology and Visual Science, Seoul St. Mary’s Hospital, The Catholic University of Korea College of Medicine, Seoul, Korea

Address reprint requests to Suk Woo Yang, MD, PhD Department of Ophthalmology, The Catholic University of Korea, Seoul St. Mary’s Hospital, #222 Banpo-daero, Seocho-gu, Seoul 137-701, Korea, Tel: 82-2-2258-1200, Fax: 82-2-599-7405, E-mail: yswoph@catholic.ac.kr

Received 8 July 201328 August 2013 Accepted 28 January 2014

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 evaluate the outcomes of endonasal or external dacryocystorhinostomy in patients who underwent radioiodine therapy due to thyroid cancer.

Methods

We reviewed retrospectively clinical and microbiological records of patients who had endonasal or external dacryocystorhinostomy after taking radioiodine therapy for thyroid cancer between January 2006 and December 2012.

Results

Twenty-three female adult patients with an average age of 50 years (range, 25 to 72 years) were identified. Seven patients underwent unilateral surgery and 16 had bilateral surgery. Among 39 eyes, 1 eye had combined nasal septoplasty, 3 eyes had external dacryocystorhinostomy and 36 eyes had endonasal dacryocystorhinostomy. Dacryocystorhinostomy was performed within 12 months after the last ¹³¹ I dose in 3 cases and 2 (5%) presented with the symptom of epiphora. The major cause of symptomatic recurrence was restenosis of the lacrimal nasal mucosa due to the formation of scar tissue, thus, the patients underwent revision surgeries. The remaining 37 of the 39 eyes (95%) showed improvement of symptoms.

Conclusions

Most patients who underwent dacryocystorhinostomy after ¹³¹ I therapy due to thyroid cancer showed successful outcomes, especially after more than 1 year post-operatively. The major cause of nasolacrimal duct obstruction was a scar tissue formation in the nasal cavity mucosa.

Keywords: Dacryocystorhinostomy, Radioactive iodine, Thyroid cancer

References

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Table 1.

Selection criteria for cases with NLDO

Indication	Contraindication
Symptoms related to epiphora	Previous history of DCR
Positive finding in fluorescein dye disappearance test	Congenital NLDO
Occlusive findings in lacrimal scintigraphy	Under 16 years-old age

Occlusive findings in syringing & probing 　

Table 2.

Demographics of patients

	Categorized	Patients (n = 23)	Eyes (n = 39)
Age (mean years, SD)		50.35 (11.12)
Female sex (%)		23 (100)
Nasolacrimal duct obstruction	Complete (%)		37 (95)
	Partial (%)		2 (5)
Dacryocystorhinostoomy	Endoscopic		36 (92)
	External		3 (8)
Complication	None (%)		37 (95)
	Adhesion ⟶ Revision (%)		2 (5)
Dose of iodine-131	>300 mCi		32 (82)
	≤300 mCi		7 (18)

Table 3.

Preoperative diagnosis

Diagnosis	n = 39 (%)
Nasolacrimal duct obstruction	33 (84.6)
Chronic dacryocystitis	1 (2.6)
Acute dacryocystitis	2 (5.1)
Distal canalicular obstruction	2 (5.1)
Common canalicular obstruction	1 (2.6)

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