Endoscopic Dacryocystorhinostomy: Creation of a Large Marsupialized Lacrimal Sac.
10.3346/jkms.2006.21.4.719
- Author:
Hong Ryul JIN
1
;
Je Yeob YEON
;
Mi Young CHOI
Author Information
1. Department of Otorhinolaryngology-Head and Neck Surgery, Seoul National University Boramae Hospital, Seoul, Korea. hrjin@paran.com
- Publication Type:Original Article
- Keywords:
Dacryocystorhinostomy;
Endoscopy;
Lacrimal Duct Obstruction;
Lacrimal Apparatus
- MeSH:
Treatment Outcome;
Surgical Flaps;
Nasal Mucosa/surgery;
Middle Aged;
Male;
Lacrimal Duct Obstruction/*surgery;
Lacrimal Apparatus/pathology/surgery;
Humans;
Follow-Up Studies;
Female;
Endoscopy/*methods;
Dacryocystorhinostomy/*methods;
Child;
Aged;
Adult;
Adolescent
- From:Journal of Korean Medical Science
2006;21(4):719-723
- CountryRepublic of Korea
- Language:English
-
Abstract:
This retrospective study describes and evaluates the effectiveness of a modified technique of conventional endoscopic dacryocystorhinostomy (DCR) that minimizes the obstruction of a neo-ostium by creating an enlarged marsupialized lacrimal sac using mucosal flaps. Forty-two patients who had undergone 46 endoscopic DCR at a tertiary medical center, from 2002 to 2004, for correction of lacrimal system obstruction were investigated. The surgical technique involves elevation of a nasal mucosal flap, full sac exposure using a power drill, and shaping of the mucosal flap to cover denuded bone and juxtapose exposed sac mucosa. Postoperative symptoms and endoscopic findings of the neo-ostium were evaluated. Mean duration of follow-up was 5.9 months. An eighty-three percent primary success rate was observed, without any serious complications. Obstruction of the neo-ostium with granulation tissue was observed in eight cases, among which six underwent revision with success in all cases. Overall, 44 (96%) of 46 cases experienced surgical successes. Endoscopic DCR, a procedure in which a large marsupialized lacrimal sac is created from mucosal flaps, yields a very satisfactory success rate with straightforward and highly successful revision available for those in whom the primary procedure yields a substandard result.
