1.The nasolacrimal duct obstruction operated by DCR with intraoperative mitomycin C
Journal of Vietnamese Medicine 1998;225(9, 10):55-60
In this prospective randomized controlled study, a total of 70 patients (76 eyes) diagnosed with acquired nasolacrimal duct obstruction operated by DCR with intraoperative mitomycin C 0.4mg/ml appication to the osteotomy site for 3 minutes. The results of the DRC surgeries were evaluated by objective findings such as irrigation, height of tear meniscuc, ostium size and subjective symptoms. Among the 76 eyes, 96% of patiets remained total symptoms free after 6 months of follow up. Mean ostium size 2.861 (0,785mm. There were no complications such as abnormal nasal bleeding, mucosal necrosis or infection
Nasolacrimal Duct
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Lacrimal Duct Obstruction
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surgery
3.Diagnosis and treatment of lacrimal passage obstruction by lacrimal endoscope.
Zhi, WANG ; Yukan, HUANG ; Wen, CHEN ; Wei, CHEN ; Mingchang, ZHANG ; Fei, CHEN
Journal of Huazhong University of Science and Technology (Medical Sciences) 2007;27(5):593-7
The diagnosis and treatment of the lacrimal passage obstruction with lacrimal endoscope was investigated and its subsidiary surgical procedures were evaluated. Ninety-three patients (109 eyes) with lacrimal passage obstruction, including presaccal canalicular obstruction (PSCO) and nasolacrimal duct obstruction (NLDO), were examined under a lacrimal endoscope, and the obstructions were treated with laser or micro-drill. All patients were followed up after the operation for 3-6 months. The difference between the laser and the micro-drill treatment was observed. During the period of follow-up, the curative rate was 82.57%. The healing rate in PSCO group and NLDO was 80.36% and 84.91% respectively (P>0.05). After treatment with the laser, the healing rate was 93.33% in the PSCO group and 66.67% in the NLDO group respectively (P<0.05). After treatment with the micro-drill, the healing rate in PSCO and NLDO groups was 65.39% and 94.28% respectively (P<0.01). The lacrimal passage obstruction can be observed and treated directly through the lacrimal endoscope. Choosing different surgical procedures in operation according to the locations of the obstruction is helpful to improve the effectiveness.
Endoscopy/*methods
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Follow-Up Studies
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Lacrimal Duct Obstruction/*diagnosis
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Lacrimal Duct Obstruction/*surgery
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Laser Therapy/*methods
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Young Adult
4.Annular electrode lacrimal duct reconstruction for improving the safety and efficacy of lacrimal stent implantation: a randomized clinical trial.
Wenxue HU ; Haike GUO ; Hailan LIAO ; Xiaohua HUANG
Journal of Southern Medical University 2016;36(1):13-19
OBJECTIVETo evaluate the effect of annular electrode lacrimal duct reconstruction in improving the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.
METHODSThis randomized clinical trial was performed to compare the efficacy, success rate of intubation, time used for stent implantation, intraoperative pain, and extubation-assciated complications between nasolacrimal stent implantation with and without annular electrode lacrimal duct reconstruction.
RESULTSA total of 119 eligible patients were enrolled in this trial. The total curative rate at 6 months of follow up after extubation was 70.9% (83/117) in these patients, and was significnatly higher in pateinets with lacrimal duct reconstruction than in those without [80.6% (54/67) vs 58.0% (29/50); χ(2)=7.093, P<0.05]. The total success rate of stent implantation was 98.3% (117/119) in all the patients initially enrolled, and two patients experienced failure of stent implantation and were excluded; the success rate was signfiicantly higher in patients initially enrolled in the lacrimal duct reconstruction group (χ(2)=6.282, P<0.05). The median time required for intubation was shorter in lacrimal duct reconstruction group (12 s vs 33 s; Z=-36.722, P<0.05). The intendity of intraoperative pain was comparable between the two groups (t=0.833, P=0.405). The total rate of puncta injury was 43.6% (51/117) in these patients and similar between the two groups (χ(2)=1.459, P=0.227). The total rate of extubation difficulty was 9.4% (11/117) in all the patients, and was lower in lacrimal duct reconstruction group [4.5% (3/67) vs 16% (8/50); χ(2)=4.463, P<0.05]. Stent breakage in extubation occurred in 4.3% (11/117) of the patients with similar rates between the two groups (χ(2)=2.964, P=0.085). Spearman bivariate correlation analysis showed that the time required for intubation was inversely correlated with the treatment efficacy (r=-0.584, P<0.05) and positively with the occurrence of extubation difficulty (r=0.491, P<0.05); extubation difficulty was inversely correlated with the curative effect (r=-0.511, P<0.05).
CONCLUSIONAnnular electrode nasolacrimal duct reconstruction can increase the safety and efficacy of nasolacrimal duct stent implantation for treatment of nasolacrimal duct obstruction.
Dacryocystorhinostomy ; methods ; Electrodes ; Humans ; Intubation ; Lacrimal Duct Obstruction ; Nasolacrimal Duct ; surgery ; Pain ; Reconstructive Surgical Procedures ; methods ; Stents ; Treatment Outcome
5.Lacrimal Intrasaccal Cyst.
Ju Hyang LEE ; Sunisa SINTUWONG ; Yoon Duck KIM ; Kyung In WOO
Korean Journal of Ophthalmology 2015;29(6):433-434
6.Clinical Outcomes of Initial and Repeated Nasolacrimal Duct Office-Based Probing for Congenital Nasolacrimal Duct Obstruction.
Deok Sun CHA ; Hwa LEE ; Min Soo PARK ; Jong Mi LEE ; Se Hyun BAEK
Korean Journal of Ophthalmology 2010;24(5):261-266
PURPOSE: To characterize the outcomes of initial and repeated office-based probing as a primary treatment for congenital nasolacrimal duct obstruction (CNLDO) in children. METHODS: The medical records of patients who underwent nasolacrimal duct office-based probing for CNLDO between March 2004 and January 2008 were reviewed retrospectively. Nasolacrimal duct probing was performed on 244 eyes from 229 consecutive patients with CNLDO. Patients who were refractory to the first probing underwent a second probing 4 to 8 weeks later. RESULTS: Based on exclusion criteria, 244 eyes from 229 patients (117 males and 112 females), aged 6 to 71 months (mean, 12.4 +/- 8.36) were included. The success rate of the initial probing was 80% (196 of 244) for all patients, 82% (111 of 136) in the 6 to 12 month age group, 79% (64 of 81) in the 13 to 18 months age group, and 78% (21 of 27) among individuals older than 19 months (p = 0.868, Pearson chi-square test). The success rate of the second probing was 61% (25 of 41) for all patients, 74% (17 of 23) in the 6 to 12 months age group, 58% (7 of 12) in the 13 to 18 months age group, and 17% (1 of 6) among individuals older than 19 months (p = 0.043, Fisher's exact test). CONCLUSIONS: While the success rate of initial nasolacrimal duct probing is not affected by age, the rate of success rate with a second probing was significantly lower in patients older than 19 months. Based on the results, authors recommend further surgical interventions, such as silicone tube intubation or balloon dacryocystoplasty, instead of repeated office probing for patients older than 19 months, if an initial office probing has failed.
Ambulatory Care
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Child
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Child, Preschool
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Female
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Humans
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Infant
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Korea
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Lacrimal Duct Obstruction/congenital/*surgery
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Male
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Nasolacrimal Duct/*surgery
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Retrospective Studies
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Treatment Outcome
7.Nasolacrimal Duct Obstruction Caused by Oncocytic Carcinoma.
Jae Ho JUNG ; Dong Hoon SHIN ; Kyu Sup CHO ; Hee Young CHOI
Korean Journal of Ophthalmology 2013;27(2):126-129
Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.
Adenoma, Oxyphilic/*complications/pathology/surgery
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Humans
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Lacrimal Duct Obstruction/*etiology/pathology/surgery
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Male
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Middle Aged
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Nasolacrimal Duct/*pathology/surgery
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Neoplasm Recurrence, Local/complications/pathology/surgery
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Nose Neoplasms/*complications/pathology/surgery
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Reoperation
8.Nasolacrimal Duct Obstruction Caused by Oncocytic Carcinoma.
Jae Ho JUNG ; Dong Hoon SHIN ; Kyu Sup CHO ; Hee Young CHOI
Korean Journal of Ophthalmology 2013;27(2):126-129
Here, we report an extremely rare case of acquired nasolacrimal duct obstruction caused by oncocytic carcinoma. A 64-year-old man presented to the hospital complaining of epiphora and left-side nasal obstruction. Ophthalmic and otolaryngology examination revealed a left lacrimal duct obstruction caused by a mass in the left nasal cavity and lacrimal drainage system. The mass was removed and confirmed as an oncocytic carcinoma. Nine months after surgery, without adjuvant radiotherapy, a left orbital mass was observed and the patient underwent reoperation. The mass proved to be recurrent oncocytic carcinoma. The patient underwent adjuvant radiotherapy to eradicate any residual tumor and the patient remains tumor-free one year post-radiotherapy.
Adenoma, Oxyphilic/*complications/pathology/surgery
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Humans
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Lacrimal Duct Obstruction/*etiology/pathology/surgery
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Male
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Middle Aged
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Nasolacrimal Duct/*pathology/surgery
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Neoplasm Recurrence, Local/complications/pathology/surgery
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Nose Neoplasms/*complications/pathology/surgery
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Reoperation
9.Endoscopic Dacryocystorhinostomy: Creation of a Large Marsupialized Lacrimal Sac.
Hong Ryul JIN ; Je Yeob YEON ; Mi Young CHOI
Journal of Korean Medical Science 2006;21(4):719-723
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.
Treatment Outcome
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Surgical Flaps
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Nasal Mucosa/surgery
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Middle Aged
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Male
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Lacrimal Duct Obstruction/*surgery
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Lacrimal Apparatus/pathology/surgery
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Humans
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Follow-Up Studies
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Female
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Endoscopy/*methods
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Dacryocystorhinostomy/*methods
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Child
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Aged
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Adult
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Adolescent
10.Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction.
Yoon Jin KONG ; Hye Sun CHOI ; Jae Woo JANG ; Sung Joo KIM ; Sun Young JANG
Korean Journal of Ophthalmology 2015;29(6):368-374
PURPOSE: This study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique. METHODS: We retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient's subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon. RESULTS: Functional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test). CONCLUSIONS: The success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.
Adult
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Aged
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Dacryocystorhinostomy/*methods
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Female
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Follow-Up Studies
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Humans
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Lacrimal Apparatus/*surgery
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Lacrimal Duct Obstruction/*therapy
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Male
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Middle Aged
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*Natural Orifice Endoscopic Surgery
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Postoperative Complications
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Retrospective Studies
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Treatment Outcome
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Young Adult