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Endoscopic dacryocystorhinostomy with mucosal anastomosing in chronic dacryocystitis with three categories of ethmoid sinuses

Authors :
Yao-Hua Wang
Wen-Hao Jiang
Yun-Hai Tu
Guang-Ming Zhou
Wen-Can Wu
Bo Yu
Source :
International Journal of Ophthalmology, Vol 15, Iss 11, Pp 1765-1771 (2022)
Publication Year :
2022
Publisher :
Press of International Journal of Ophthalmology (IJO PRESS), 2022.

Abstract

AIM: To evaluate the outcome of endoscopic dacryocystorhinostomy (En-DCR) with mucosal anastomosis in chronic dacryocystitis patients, with various categories of ethmoid sinuses. METHODS: Between July 2015 and September 2019, 1439 adult patients, representing 1623 affected eyes, presented with chronic dacryocystitis and were scheduled for En-DCR. The categories of ethmoid sinuses were preoperatively determined, using computed tomography-dacryocystography (CT-DCG), and were classified as category 1 (C1), category 2 (C2), and category 3 (C3). No sinuses anterior to the posterior lacrimal crest defined as C1. Sinuses found between the anterior edge of the lacrimal bone and the posterior lacrimal crest defined as C2. Sinuses found anterior to the lacrimal bone suture defined as C3. At the end of surgery, the dacryocyst and nasal mucosa were anastomosed in C1, and the dacryocyst mucosa and anterior ethmoid sinus were anastomosed in C2 and C3 ethmoid sinus patients. The surgical success rate and related complications, in patients with 3 categories of ethmoid cells, were monitored and documented. RESULTS: Postoperative data was obtained for 179 C1 affected eyes, 878 C2 affected eyes, and 432 C3 affected eyes. The overall success rate of En-DCR was 93.0% (1385/1489). Additionally, the success rates were comparable among the different ethmoid categories at 12mo post operation. We demonstrated that the major reason for surgical failure was intranasal ostial closure, due to granulation or scar tissue. CONCLUSION: En-DCR is a feasible and highly effective primary treatment for chronic dacryocystitis. To ensure surgical success, the surgery protocol must be designed in accordance with the category of ethmoid sinuses present in individual patient.

Details

Language :
English
ISSN :
22223959 and 22274898
Volume :
15
Issue :
11
Database :
Directory of Open Access Journals
Journal :
International Journal of Ophthalmology
Publication Type :
Academic Journal
Accession number :
edsdoj.42c345d8214457bbf36963ac458d15
Document Type :
article
Full Text :
https://doi.org/10.18240/ijo.2022.11.06