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I-shaped incision with mucosal flap preserving technique in endoscopic dacrocystorhinostomy
The Egyptian Journal of Otolaryngology volume 34, pages173–178(2018)
Epiphora due to nasolacrimal duct obstruction accounts for ~3% of all general ophthalmology visits. Endoscopic dacryocystorhinostomy (DCR) has become accepted as a suitable treatment for patients with obstructions of the lacrimal system at the level of the sac or below it. Modification of endoscopic DCR is realized by using the overlapping flaps between the lacrimal sac and nasal mucosa with the creation of a wide bony ostium by drilling out the bony borders of the lacrimal sac.
To assess the rate of patency of rhinostome after endoscopic DCR with mucosal flap preservation technique in the treatment of nasolacrimal duct obstruction.
Patients and Methods
The study population was 30 patients suffering from epiphora due to obstructive lacrimal drainage disorders attending the ORL clinic who were referred from the Ophthalmology Clinic in Suez Canal University Hospital. Patients included in the study had been subjected to the following procedures: full history taking, eye and ORL examinations, diagnostic procedures (dye disappearance test – Jones test I and II), routine preoperative investigations, and endoscopic DCR with mucosal preservation flap technique surgery.
Most of the patients were women (70%). The patients’ age ranged from 18 to 65 years old. All patients complained of epiphora, 50% had punctual discharge, and 26.6% had lacrimal sac swelling before the operation. The success rate of the operation was 90%.
We conclude that the low complication and high success rate indicate that EN-DCR with a large bony ostium and large nasal mucosal flap opposed with lacrimal sac flaps can be considered as a better technique in the treatment of lacrimal system obstructions.
Woog JJ. The incidence of symptomatic acquired lacrimal outflow obstruction among residents of Olmsted County, Minnesota, 1976–2000 (an American Ophthalmological Society thesis). Trans Am Ophthalmol Soc 2007; 105:649–666.
Trimarchi M, Resti AG, Bellini C, Forti M, Bussi M. Anastomosis of nasal mucosal and lacrimal sac flaps in endoscopic dacryocystorhinostomy. Eur Archi Otorhinolaryngol 2009; 266:11.
Yigit O, Samancioglu M, Taskin U, Ceylan S, Eltutar K, Yener M. External and endoscopic dacryocystorhinostomy in chronic dacryocystitis: comparison of results. Eur Arch Otorhinolaryngol 2007; 264:879–885.
Rajput R, Chandrashekar R, Kumar S. Our experience in endoscopic dacryocystorhinostomy in 203 patients. Res Otolaryngol 2015; 4:10–12.
Önerci M, Orhan M, Öğretmenoglu O, İrkeç M. Long-term results and reasons for failure of intranasal endoscopic dacryocystorhinostomy. Acta Otolaryngol 2000; 120:319–322.
Tsirbas A, Davis G, Wormald PJ. Revision dacryocystorhinostomy: a comparison of endoscopic and external techniques. Am J Rhinol 2005; 19:322–325.
Huang J, Malek J, Chin D, Snidvongs K, Wilcsek G, Tumuluri K, et al. Systematic review and meta-analysis on outcomes for endoscopic versus external dacryocystorhinostomy. Orbit 2014; 33:81–90.
Telang R, Maheshwary M, Joshi S. A study of endoscopic endonasal dacrocystorhinostomy with mucosal flap technique. J Evid Based Med Healthcare 2015; 2:8050–8059.
Harvinder S, Rosalind S, Philip R, Mallina S, Gurdeep S. Powered dacrocystorhinostomy with mucosal flap without stenting. Med J Malaysia 2008; 63:237–238.
Goyal R, Gupta S. Analysis of 104 cases of endonasal dacrocystorhinostomy in a tertiary care hospital: a prospective study. Indian J Otolaryngol Head Neck Surg 2014; 66:102–105.
Çukurova I, Mercan GC, Çetinkaya E, Gümüsssoy M, Söken H. Endoscopic dacryocystorhinostomy: outcomes using mucosal flap preserving technique. Eur Arch Otorhinolaryngol 2013; 270:1661–1666.
Ramakrishnan VR, Hink EM, Durairaj VD. Outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation. Am J Rhinol 2007; 21:753–757.
Kansu L, Aydin E, Avci S, Kal A, Gedik S. Comparison of surgical outcomes of endonasal dacryocystorhinostomy with or without mucosal flaps. Auris Nasus Larynx 2009; 36:555–559.
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Hassan, M.A., Badreldin, M.H., El-Nahriry, T. et al. I-shaped incision with mucosal flap preserving technique in endoscopic dacrocystorhinostomy. Egypt J Otolaryngol 34, 173–178 (2018). https://doi.org/10.4103/ejo.ejo_42_17
- tear sac flaps during endoscopic dacryocystorhinostomy