Cause and Management of Patients With Failed Endonasal Dacryocystorhinostomy.
- Author:
Ji Sun BAEK
1
;
Seong Hun JEONG
;
Jung Hye LEE
;
Hye Sun CHOI
;
Sung Joo KIM
;
Jae Woo JANG
Author Information
- Publication Type:Original Article
- Keywords: Failed Endonasal Dacryocystorhinostomy; Revision Surgery; Functional Epiphora
- MeSH: Dacryocystorhinostomy*; Endoscopy; Fluorescein; Follow-Up Studies; Humans; Intubation; Lacrimal Apparatus Diseases; Methods; Nasolacrimal Duct; Retrospective Studies; Silicon; Silicones; Tears
- From:Clinical and Experimental Otorhinolaryngology 2017;10(1):85-90
- CountryRepublic of Korea
- Language:English
- Abstract: OBJECTIVES: Endonasal dacryocystorhinostomy (DCR) is a well-established treatment method in patients with nasolacrimal duct obstruction. However, there are a few reports about the overall management of failed endonasal DCR. We investigated the causes and management strategies of failed endonasal DCR. METHODS: This retrospective review included 61 patients (61 eyes) who had undergone revision surgery by the same surgeon after failed endonasal DCR between January 2008 and December 2012. The appropriate revision method was determined after analysis of the etiology of failure by the fluorescein dye disappearance test, nasal endoscopy, lacrimal irrigation, and probing. The criteria for success of the revision surgery were defined by the passage of fluid without resistance upon lacrimal irrigation and normalization of the tear meniscus height. RESULTS: The mean duration between the primary endonasal DCR and revision surgery was 15.3 months. The average follow-up period after revision surgery was 12.2 months. The most common cause of endoscopic revision surgery was membranous obstruction. Endoscopic revision surgery was performed in 48 patients, while lacrimal silicone tube intubation under endoscopy was performed in 13 patients. The most common indication for lacrimal silicone tube intubation was functional epiphora. The overall success rate of the revision surgery was 89%. CONCLUSION: The most common cause of failed endonasal DCR was membranous obstruction. When patients with failed endonasal DCR presented at the clinic, it is important to identify the cause of the failure. Revision surgery could increase the final success rate of endonasal DCR.
