Compared outcomes of using histoacryl and tube insertion for endoscopic endonasal dacryocystorhinostomy surgery
- VernacularTitle:Дурангаар хийгдэх дакриоцисториностомийн үед нулимсны замд силикон гуурс суулгах болон хистоакрил цавуу хэрэглэсэн үр дүн
- Author:
Ariunbold Tumenjargal
1
;
Yen Chang Chu
2
Author Information
1. Department of Ophthalmology, Orbita Eye Hospital
2. Department of Ophthalmology, Chang Gung Memorial Hospital, Chang Gung University, College of Medicine, Linkou, Taiwan
- Publication Type:Journal Article
- Keywords:
Dacryocystitis;
Lacrimal sac;
Nasal flap;
Silicone tube;
Tissue glue
- From:Mongolian Medical Sciences
2021;198(4):15-19
- CountryMongolia
- Language:Mongolian
-
Abstract:
Introduction:Dacryocystorhinostomy (DCR) is a surgical treatment for site of obstruction in the nasolacrimal
duct system. This surgery is performed in cases of congenital nasolacrimal obstruction, partial and
complete occlusion of the nasolacrimal duct in adults, chronic tearing disorders, ineffective probing
treatment and placement of a silicone tube in the nasolacrimal system. the present findings indicate
that preservation of lacrimal sac flaps with end-to-end anastomosis to the nasal mucosa using
histoacryl has a positive impact on surgical outcome in patients undergoing endonasal endoscopic
dacryocystorhinostomy. Histoacryl glue is one of the most commonly surgical materials used recently.
The basis of our study is the lack of research on the use of this glue in the practice of oculoplastic
and reconstructive surgery.
Purpose:To report the use of fibrin glue as an adjunctive procedure in endoscopic dacryocystorhinostomy (En-DCR) surgery and compare it to silicone tubing
Material and Method:Patients with primary nasolacrimal duct obstruction were retrospectively reviewed for endo-DCR
between January 2017 and December 2019. Group I patients applied fibrin glue and Group II used
silicone tube insertion. The fibrin glue group received end-to-end anastomosis of the nasal mucosa
and lacrimal sac using fibrin glue at the end of surgery. The demographics, recurrence, causes of
failure, formation of scars, final ostium size and the success rate were compared. This study was
approved by the Institutional Review Board of the Chang Gung Memorial Hospital Clinical Research
Ethnics Committee and followed the Declaration of Helsinki. All statistical analysis was performed
with SPSS version 24.0 software (SPSS Inc., Chicago, IL, USA), and a P value < .05 was considered
statistically significant. Continuous variables were presented as mean ± standard deviation, while
categorical data was represented as numbers and percentages. Independent t-tests were used
to compare the differences in parametric variables. The Mann-Whitney U test was performed to
compare the follow-up period. Pearson’s chi-squared and Fisher’s exact tests were used to compare
categorical variables. Multivariate logistic regression was used to identify the risk factors associated
with recurrence.
Result:The age of the whole cases was between 17 and 82 years. There was no significant difference
among the age groups. In terms of gender, n=48 (78.7%) were female and n=13 (21.3%) were male,
indicating that dacryocystitis was predominant in women. Study reports no significant difference in
intraoperative and postoperative complication. The surgical success rate was significantly higher in
histoacryl group 94.9%, than silicone tube group 79.5%. Recurrent cases n=2 (5.1%) in group 1 and
n=9 (20.4%) in group 2 respectively.
Conclusion:Fibrin glue improves the surgical outcome in patients undergoing Endo-DCR compared
to commonly used silicone stenting by securing flaps apposition and maintaining the ostium opening.
- Full text:2021-198(4)-15-19.pdf
