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Kim, You, and Min: The Clinical Outcome of Endoscopic Endonasal Silicone Tube Intubation According to Nasolacrimal Duct Resistance
Original Article

J Korean Ophthalmol Soc 2015;57(1):1-5.

Published online: 29 August 2015

DOI: https://doi.org/10.3341/jkos.2016.57.1.1

The Clinical Outcome of Endoscopic Endonasal Silicone Tube Intubation According to Nasolacrimal Duct Resistance

Joon Hyung Kim, M.D1, In Cheon You, M.D, PhD1, 2, 3, Ahn Min, M.D PhD1, 2, 3,

1Department of Ophthalmology, Chonbuk National University Medical School, Jeonju, Korea

2Research Institute of Clinical Medicine, Chonbuk National University, Jeonju, Korea

3Biomedical Research Institute, Chonbuk National University Hospital, Jeonju, Korea

Address reprint requests to Min Ahn, MD, PhD Department of Ophthalmology, Chonbuk National University Hospital, #20 Geonji-ro Deokjin-gu, Jeonju 54907, Korea Tel: 82-63-250-1878, Fax: 82-63-250-1960 E-mail: ahnmin@jbnu.ac.kr

‗ This paper was supported by Fund of Biomedical Research Institute, Chonbuk National University Hospital.

Received 9 January 201512 October 2015       Accepted 26 November 2015

Copyright © 2015 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 evaluate the clinical result of silicone tube intubation through Hasner’s valve according to nasolacrimal duct resist-ance under intranasal endoscopic guidance in partial acquired nasolacrimal duct obstruction patients.

Methods

The present study enrolled a total of 50 eyes from 31 patients diagnosed with partial acquired nasolacrimal duct ob-struction in the Department of Ophthalmology, Chonbuk National University Hospital from 2012 January to 2012 December. Silicone tube intubation was done through the Hasner’s valve and confirmed by intranasal endoscopy and the nasolacrimal duct resistance was measured. Success was defined as the disappearance of epiphora, and failure was defined as the maintenance of epiphora after silicone tube intubation.

Results

There were 8 male patients and 23 female patients, ages between 32 to 80 and the average age was 61.4 years old. 3 eyes of 3 patients (6%) had no resistance, 26 eyes of 17 patients (52%) had mild resistance, 17 eyes of 15 patients (34%) had moderate resistance and 4 eyes of 3 patients (8%) had severe resistance. The success was 44 eyes (88%) and the failure was 6 eyes (12%). In the no resistance and mild resistance groups the success rates were both 100%, while an 82% of success rate in the moderate resistance group and 25% success rate in the severe resistance group were observed. The success rates showed clear distinction between severe, moderate and mild resistance patients.

Conclusions

Ensuring the passage of a silicone tube through Hasner’s valve increases the success rate in the functional aspect; however, the resistance of the nasolacrimal duct can highly influence the success rate. Therefore, if a patient has severe nasola-crimal duct resistance, dacryocystorhinostomy should be considered earlier.

Keywords: Endoscopic silicone tube intubation, Epiphora, Hasner’s valve, Nasolacrimal duct obstruction, Resistance

References

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Figure 1.
Intraoperative findings. (A) Intranasal endoscopic observation of Hasner's valve. (B) Ensuring the passage of probe by intranasal endoscopy.
jkos-57-1f1.tif
Table 1.
Demographic data of the patients
Factor N = 31 (eye = 51) %
Sex
 Male 8 (10) 25
 Female 23 (40) 75
Age
 31-40 years old 1 3.1
 41-50 years old 3 9.7
 51-60 years old 10 32.3
 61-70 years old 10 32.3
 71-80 years old 7 22.6
 Mean ± SD (years old) 61.4 ± 10.8
Side
 Right (24) 48
 Left (26) 52
 Both 19
Resistance
 No resistance (3) 6
 Mild resistance (26) 52
 Moderate resistance (17) 34
 Severe resistance (4) 8

Values are presented as mean ± SD unless otherwise indicated.

Table 2.
Success rate of endoscopic endonasal silicone tube in tubation
N Success rate (%)
No resistance 4 100
Mild resistance 26 100
Moderate resistance 17 82
Severe resistance 4 25
Total 51 88
Table 3.
ANOVA between resistance groups
Sum of square Degree of freedom Root mean square F S Significance probability
Between groups 2.059 3 0.686 9.805 0.000*
Within groups 3.221 46 0.070
Total 5.280 49

ANOVA = one-way analysis of variance.

* p<0.05 statistically significant.

Table 4.
Post-hoc analysis between resistance groups
Resistance N Subset for alpha = 0.05
1 2
Severe resistance 4 0.25
Moderate resistance 17 0.82
No resistance 3 1.00
Mild resistance 26 1.00
Significance probability 1.000 0.288

Means for groups in homogenous subsets are displayed. Duncan.*,† * Uses Harmonic Mean sample size = 6.697; † The group sizes are unequal. The harmonic mean of the group sizes is used. Type I er-ror levels are not guaranteed.

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