Efficacy of nasolacrimal duct stent placement combined with endonasal endoscopic dacryocystorhinostomy in the treatment of chronic dacryocystitis and recurrence rate analysis
10.3760/cma.j.cn341190-20240825-01086
- VernacularTitle:EES-DCR治疗慢性泪囊炎疗效及复发率分析
- Author:
Lijuan LI
1
;
Peng CHEN
1
;
Songyu ZHAI
1
;
Shanghua SONG
1
Author Information
1. 西安市人民医院(西安市第四医院)耳鼻咽喉头颈外科，西安 710004
- Publication Type:Journal Article
- Keywords:
Dacryocystitis;
Nasolacrimal duct;
Dacryocystorhinostomy;
Lacrimal apparatus diseases;
Endoscopes;
Postoperative complications;
Recurrence
- From:
Chinese Journal of Primary Medicine and Pharmacy
2025;32(7):1044-1049
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To investigate the efficacy of nasolacrimal duct stent placement combined with endonasal endoscopic dacryocystorhinostomy (EES-DCR) in the treatment of chronic dacryocystitis and analyze the recurrence rate of this condition.Methods:A retrospective analysis was performed on 312 patients with chronic dacryocystitis admitted to Department of Otolaryngology Head and Neck Surgery, Xi'an People's Hospital (Xi'an Fourth Hospital) from April 2021 to April 2023. All patients were divided into the non-implantation group (EES-DCR only) and the implantation group (nasolacrimal duct stent placement combined with EES-DCR) based on the surgical procedure used. Baseline data were excluded using propensity score matching method, and 156 patients were included in each group. Clinical efficacy, incidence rates of complications, and epiphora status (epiphora degree, tear film breakup time, Schirmer test strip wetting length) before surgery and at 1 month after surgery, as well as recurrence rate within 1 year of treatment were compared between the two groups.Results:The total efficacy in the implantation group was significantly higher than that in the non-implantation group [98.08% (153/156) vs. 93.59% (146/156), χ2 = 3.93, P = 0.047). The overall incidence rate in the implantation group was significantly lower than that in the non-implantation group [5.13% (8/156) vs. 12.18% (19/156), χ2 = 4.90, P = 0.027). At 1 month after surgery, both the degree of epiphora and the wetting length of Schirmer test strip significantly decreased in both groups, while the tear film breakup time significantly increased (both P < 0.05) compared with before surgery. The degree of epiphora and the wetting length of Schirmer test strip in the implantation group were (1.25 ± 0.26) points and (12.37 ± 2.24) mm, respectively, which were significantly lower than those in the non-implantation group [(1.44 ± 0.29) points, (13.32 ± 2.60) mm, t = 4.81, P < 0.001; t = 3.45, P < 0.001]. The tear film breakup time in the implantation group was (12.43 ± 2.31) seconds, which was significantly longer than that in the non-implantation group [(11.38 ± 2.15) seconds, t = 4.15, P < 0.001]. The total recurrence rate in the implantation group was 5.13% (8/156), which was significantly lower than that in the non-implantation group [11.54% (18/156), χ2 = 4.19, P = 0.041]. Conclusions:Nasolacrimal duct stent placement combined with EES-DCR effectively treats chronic dacryocystitis, reduces the degree of epiphora, and lowers the recurrence rate of the disease. This combined therapy has few complications and is safe and effective.
