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Jung and Lee: Effects of Triamcinolone-soaked Packing for Endonasal Revision in Patients with Failed Endoscopic Dacryocystorhinostomy
Case Report

Journal of the Korean Ophthalmological Society 2017; 58(5): 586-590.

Published online: 15 May 2017

DOI: https://doi.org/10.3341/jkos.2017.58.5.586

Effects of Triamcinolone-soaked Packing for Endonasal Revision in Patients with Failed Endoscopic Dacryocystorhinostomy

Young Hoon Jung, MD, Ka Hyun Lee, MD

Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea.

Address reprint requests to Ka Hyun Lee, MD. Department of Ophthalmology, Konyang University College of Medicine, Daejeon, Korea. Tel: 82-42-600-9258, Fax: 82-42-600-9251, chullan@kyuh.ac.kr

Received 12 January 2017       Revised 8 March 2017       Accepted 19 April 2017

©2017 The Korean Ophthalmological Society

(open-access):

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 efficacy of endonasal revision using triamcinolone-soaked nasal packing in patients exhibiting recurrence of epiphora after endoscopic dacryocystorhinostomy.

Case summary

Four patients (4 eyes) who presented with the chief complaint of recurrence of epiphora after endoscopic dacryocystorhinostomy underwent endonasal revision under local anesthesia. On nasal endoscopy, granulation tissue and membranous tissue around the osseous foramen was removed during endonasal revision. According to the operator's judgement, the osseous foramen was additionally expanded. Following insertion of a silicone tube, triamcinolone-soaked nasal packing was used for intra-nasal packing. The silicone tube was removed after follow-up of more than 12 weeks. Immediately after removing the silicone tube, there was free passage of saline on lacrimal syringing as well as complete resolution of epiphora. At over 6 months of follow-up after tube removal, there was no recurrence of epiphora in any of the 4 patients.

Conclusions

Triamcinolone-soaked nasal packing may be considered in patients with failed endoscopic dacryocystorhinostomy.

Keywords: Endonasal revision, Endoscopic dacryocystorhinostomy, Nasopore, Triamcinolone

Figures and Tables

Figure 1

Endoscopic view of case 1. (A) Granulomatous obstruction of bony opening at 2 months after endonasal dacryocystorhinostomy (arrow). (B) After 2 weeks of removal of granulomatous tissue and silicone tube insertion using triamcinolone-soaked synthetic sponge (Nasopore®). (C) Patent bony opening at 6 months after tube removal.

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Figure 2

Endoscopic view of case 4. (A) Membranous obstruction of bony opening at 3 months after endonasal dacryocystorhinostomy (arrow). (B) After removal of membranous tissue, silicone tube insertion and triamcinolone-soaked synthetic sponge (Nasopore®) was used for the intra-nasal packing. (C) Patent bony opening at 6 months after tube removal.

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Table 1

Demographics and clinical features of the patients undergoing endonasal revision using triamcinolone acetonide-soaked Nasopore®

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F = female; M = male; EDCR = endoscopic dacryocystorhinostomy.

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