Search Results (4)

Objectives: To prospectively compare the outcomes of external dacryocystorhinostomy (EX-DCR), endonasal dacryocystorhinostomy (EN-DCR), and laser-assisted transcanalicular dacryocystorhinostomy (TL-DCR) in patients with nasolacrimal duct obstruction (NLDO) and to evaluate the relationship between surgical outcomes and patient quality of life (QoL). Methods: This prospective comparative study included patients presenting with epiphora who were diagnosed with NLDO and scheduled for surgical treatment. Patients underwent EX-DCR, EN-DCR, or TL-DCR according to patient preference and nasal anatomical characteristics. All patients received bicanalicular silicone tube intubation. Follow-up examinations were performed on postoperative day 1, week 1, at month 1, and every three months thereafter. Anatomical success was defined as patency on nasolacrimal irrigation, and functional success was defined as a postoperative Munk score of ≤ 1 (complete or near-complete resolution of epiphora). QoL was assessed using the Lacrimal Symptom Questionnaire (Lac-Q) and the Glasgow Benefit Inventory (GBI). Statistical comparisons were performed between groups. Results: A total of 69 patients (45 women, 24 men; mean age 58.99 ± 14.86 years) were included, with a mean follow-up of 17.19 ± 4.07 months. The highest postoperative pain scores were observed in the EX-DCR group; with no significant intergroup differences. Anatomical success rates were 92% for EX-DCR, 90.5% for EN-DCR, and 91.3% for TL-DCR. Functional success rates were 88%, 90.5%, and 82.7%, respectively, with no statistically significant difference among techniques (p > 0.05). All groups showed postoperative improvement in Lac-Q and GBI scores. Numerically greater improvements were observed in the EN-DCR group, although intergroup differences were not statistically significant. Conclusions: EX-DCR achieved the numerically highest anatomical success rate, whereas EN-DCR demonstrated numerically greater improvement in patient-reported QoL outcomes. However, no statistically significant differences in anatomical success, functional success, or QoL measures were observed among the three techniques. Overall, all three procedures were effective surgical options for the treatment of NLDO. Full article

Background/Objectives: This study aims to depict trends in Endoscopic Dacryocystorhinostomy research in Asian countries. Methods: A bibliometric analysis was performed in April 2024 utilizing the SCOPUS database. The keywords “Endoscopic Dacryocystorhinostomy” OR “Endo-DCR” OR “Endonasal Endoscopic Dacryocystorhinostomy” were used. Data cleaning was then performed. Microsoft Excel and Vosviewer software were used to analyze data. Results: 730 articles and 37 keywords were yielded after exclusion. Our analysis revealed a notable increase in Endoscopic Dacrycocystorhinostomy publications from the early 2000s, with a significant surge post-2010. India and China were the leading contributors to Endoscopic Dacryocystorhinostomy research in Asia. Keywords such as “endoscopy”, “silicone tube”, and “epiphora” were commonly used. However, keywords like “mitomycin C”, “mucosal flap” and “success rate” were infrequently found. Conclusions: The emergence of Endoscopic Dacryocystorhinostomy publications witnessed a notable increase from 1972 to 2023 with most studies affiliated to India and China. Certain keywords such as “mitomycin C”, “mucosal flap”, “revision”, “laser”, “drill”, and “success rate” were infrequently used. Full article

Background/Objectives: Although endoscopic dacryocystorhinostomy (DCR) has been widely accepted as the procedure of choice for nasolacrimal duct obstruction (NLDO) management due to most etiologies, concerns regarding the reactivation of disease and involvement of surrounding structures add to hesitation in its utilization for granulomatosis with polyangiitis (GPA) patients. No study has directly compared outcomes of external vs. endoscopic DCR in GPA patients. This information can be helpful for patient counselling and choosing a personalized surgical approach for the best results. Methods: A scoping review of the literature was performed in January 2024. The following databases were searched using a combination of MeSH (Medical Subject Headings) and keywords: Ovid MEDLINE, Ovid EMBASE, Scopus, and Web of Science. This scoping review is not registered. Medical records of two GPA patients who underwent endoscopic DCR at our center were reviewed. Results: The search yielded 96 articles; 15 articles met the inclusion criteria for a full review. Six studies with 22 procedures reported 100% success with endoscopic DCR. Nine studies with 122 procedures reported success in 88.5% of cases with external DCRs. Additional perioperative immunosuppression was recommended in patients with severe mucosal inflammation. The case series presents the disease course, details of surgery, and perioperative management in two GPA patients with NLDO who underwent endoscopic DCR successfully. Conclusions: Endoscopic DCR was associated with equivalent or better success rates and lower complications compared to external DCR in GPA patients. Ensuring disease remission state and appropriate immunomodulatory therapy can help prevent the proposed risk of endonasal disease reactivation with endoscopic DCR. Full article

Background: Anti-glaucoma eye drops have been investigated due to their production of fibrotic changes on the conjunctival surface, undermining the functioning of the upper lacrimal drainage system. We aimed to assess whether these effects may impair the effectiveness of endoscopic endonasal dacryocystorhinostomy (EE-DCR). Methods: This is a single-center observational retrospective study on EE-DCR via a posterior approach. Resolution of epiphora and dacryocystitis were analyzed after 1 (T1) and 6-months (T2) from surgery. Surgical success was defined as anatomical (patency at irrigation, no recurring dacryocystitis) or complete (zeroing of Munk score). Results: Twenty patients (32 sides) were enrolled. Preoperatively, 93.75% (n = 30/32) presented severe (Munk 3–4) epiphora and 68.75% (n = 22/32) recurrent dacryocystitis. At T1, 50.0% (n = 16/32) were referred with residual epiphora (Munk ≥ 1) and 18.75% (n = 6/32) dacryocystitis. At T2, 31.25% (n = 10/32) still complained of epiphora (Munk ≥ 1) and 6.25% (n = 2/32) dacryocystitis. Difference of outcomes at aggregate and paired timepoints (except for T1 versus T2) resulted in statistical significance (p < 0.05). At T2, 22 (68.75%) complete, 8 (25.0%) anatomical successes and 2 (6.25%) surgical failures were observed. Conclusions: Despite the chronic uptake of anti-glaucoma eye drops, EE-DCR guaranteed high rates of clinical relief from epiphora and remarkable decreases in the rates of recurrent dacryocystitis. Full article