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 ; Lacrimal Duct Obstruction ; surgery

Dacryocystorhinostomy ; Humans ; Lacrimal Duct Obstruction ; Nasolacrimal Duct/surgery*

PURPOSE: The clinical effectiveness of monocanalicular or bicanalicular intubation with sequential probing was evaluated in patients over the age of 24 months with congenital nasolacrimal duct obstruction. METHODS: Patients over 24 months of age with congenital nasolacrimal duct obstruction who underwent monocanalicular intubation with sequential probing (19 patients, 20 eyes) or bicanalicular intubation with sequential probing (22 patients, 22 eyes) were studied. Success rates and complications were evaluated. Silicone tube was removed 6 months after surgery. Success was defined as no epiphora and no retention on fluorescein dye disappearance test. RESULTS: The success rate was 95.0% (19 eyes / 20 eyes) in the monocanalicular intubation group and complications included 7 cases of early tube dislodgement, which achieved successful outcome. The success rate was 82.6% (19 eyes / 22 eyes) in the bicanalicular intubation group and complications included 4 cases of punctal slitting, and 3 cases of tube extrusion. The success and complication rates were not significantly different between the 2 groups (p = 0.608, p = 1.000, respectively). CONCLUSIONS: In congenital nasolacrimal duct obstruction, the monocanalicular tube intubation group had similar success and complication rates to the bicanalicular tube intubation group. Silicone tube maintenance for 2 months in the monocanalicular group and for 3 months in the bicanalicular group was sufficient.
Fluorescein ; General Surgery ; Humans ; Intubation* ; Lacrimal Apparatus Diseases ; Nasolacrimal Duct* ; Silicones

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

An infant presented with persistent epiphora after successful probing of the lacrimal system. Examination of the nose showed a cystic structure occluding lower portion of the lacrimal drainage system. In cases of recurrent obstruction, nasal examination and endoscopic marsupialization may help guide the clinician towards the most appropriate treatment.
Cysts/*complications/surgery ; Dacryocystitis/*complications/surgery ; Endoscopy ; Female ; Humans ; Infant ; Lacrimal Apparatus Diseases/*complications/surgery ; *Nasolacrimal Duct ; Recurrence

OBJECTIVE: To get a method of dacryocyst allocation for dacryocystorhinostomy per nasal endoscope. METHOD: The dacryocyst of 7 chronic dacryocystitis cases(8 eyes) were located through nasal cavity guided by endo-ophthalmic optical fiber. RESULT: All the 7 patients got successful operations, the bleeding was 10-20 ml during the operation , postoperative recovery was good, no infection occurred. Five patients received operations twice, all of them were detained anaesthetic tubes for 3 to 6 months, dacryocyst rinsing were conducted once per month after extubation. No obstructions and complications occurred after one year follow up. CONCLUSION Endo ophthalmic optical fiber can be used to locate dacryocyst in dacryocystorhinostomy per nasal endoscope.
Adult ; Dacryocystitis ; surgery ; Dacryocystorhinostomy ; methods ; Eye ; Female ; Humans ; Male ; Middle Aged ; Nasolacrimal Duct ; surgery ; Nose ; surgery ; Optical Fibers ; Treatment Outcome

OBJECTIVE: To explore a method for locating the area of lacrimal sac in dacryocystorhinostomy under endoscopy. METHOD: Sixty-eight patients were performed dacryocystorhinostomy under endoscopy. Take light spot of ocular optic fiber as the lacrimal sac projection to the lateral wall of the nasal cavity position. RESULT: With the guiding of ocular optic fiber, lacrimal sac can be located accurately. The operating time of dacryocystorhinostomy under endoscopy was shortened significantly, and the operation procedure was simplified. All patients were followed up for 2 years, only 2 recurrent cases were found. The success rate reach to 97.06% (66/68). CONCLUSION Ocular optical fiber used in locating the lacrimal sac in dacryocystorhinostomy under endoscopy is simple and feasible, and can be widely used.
Adult ; Dacryocystitis ; surgery ; Dacryocystorhinostomy ; methods ; Endoscopy ; Female ; Fiber Optic Technology ; Humans ; Male ; Middle Aged ; Nasolacrimal Duct ; surgery ; Recurrence ; Treatment Outcome

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 ; Child ; Child, Preschool ; Female ; Humans ; Infant ; Korea ; Lacrimal Duct Obstruction/congenital/*surgery ; Male ; Nasolacrimal Duct/*surgery ; Retrospective Studies ; Treatment Outcome

OBJECTIVE: To evaluate the efficacy of the endoscopic maxillary sinus surgery by lateral wall fenestration of the inferior nasal meatus (EMSLWF). METHOD: Based on traditional Messerklinger sinus surgery, we treat the 17 cases with maxillary sinus disorder by lateral wall fenestration of the inferior nasal meatus, removing the polyp, hemangioma, inverting papilloma, invasive sinus aspergillosis etc, trans aperture maxillary and intranasal window. RESULT: The maxillary sinuses of the 17 cases are clean. Mucosa are well recovered and drained of the mid dle and inferior nasal meatus. We did not find the nasal mucosa pathological changes like the fluid-filled blisters or edema etc. The intranasal windows are closed in only 2 cases (4.25%) after about 2 months. The maxillary sinuses of all cases are still clean with no recurrence of primary diseases. CONCLUSION The EMSLWF is well suitable for dealing with the maxillary sinus diseases. Meanwhile, before the function of the nasal mucociliary transportation system recovered in the perioperative period, the gravity drainage affection should be kept by the intranasal win dow in the inferior nasal meatus. The EMSLWF is worthy of more attention in clinic.
Adolescent ; Adult ; Aged ; Endoscopy ; Female ; Humans ; Male ; Maxillary Sinus ; surgery ; Middle Aged ; Nasal Cavity ; surgery ; Nasolacrimal Duct ; surgery ; Nose ; surgery ; Paranasal Sinus Diseases ; surgery ; Young Adult

OBJECTIVETo study the therapeutic efficiency and efficacy of laser-directing approach on searching for the nasal broken end of lacerated lacrimal canaliculus in anastomosis for canalicular laceration.

METHODSForty-nine patients (49 eyes) suffering from traumatic inferior canalicular laceration were divided into control group and laser-directing group. The distance between the lacrimal punctum and the nasal broken end of lacerated lacrimal canaliculus was more than 6 mm. During the course of management of eyelid trauma, the patients were treated by canalicular anastomosis operation with traditional method and laser-directing method in searching for the nasal broken end of lacerated lacrimal canaliculus respectively. The silicone tube of 1 mm diameter was intubated in the lacrimal passage as a stent for 4 to 6 months.

RESULTSIn the laser-directing group, the mean time in searching for the nasal broken end of lacerated lacrimal canaliculus was (5.75+/-1.49) minutes and the mean time of operation was (49.21+/-3.37) minutes; both were significantly shorter than that of the control group (P<0.01). The cure rate of the laser-directing group was 96.55%, higher than that of the control group but without statistical significance (P>0.05).

CONCLUSIONSThe laser-directing method is much quicker and more convenient to searching for the nasal broken end of the lacerated lacrimal canaliculus than the traditional approach, and patients suffer less pain and damaging in canalicular anastomosis operation.

Adolescent ; Adult ; Anastomosis, Surgical ; Eye Injuries ; surgery ; Eyelids ; injuries ; surgery ; Female ; Humans ; Lacerations ; surgery ; Lasers ; Male ; Middle Aged ; Nasolacrimal Duct ; injuries ; surgery ; Stents ; Treatment Outcome