Relevance. Effective treatment of chronic dacryocystitis (CD) remains an urgent problem of modern ophthalmology and rhinology. When studying this issue, not enough attention is always paid to complications.
Objective – to analyze the existing complications in the surgical treatment of patients with СD.
Material and methods. The study group (1st group) consisted of 45 patients with CD, who underwent endonasal endoscopic dacryocystorhinostomy (EEDCR) according to the developed own method, the comparison group (2nd group) included 36 patients who after performing the developed EEDCR a polyvinyl chloride (PVC) conductor was installed in the area of the dacryorhinostoma. The control group (3rd group) included 28 patients who underwent EEDCR according to the traditional method: with the preservation and plastic placement of mucous flaps and with the installation of PVC-conductor. Patients of the 1st and 2nd groups were divided into 2 subgroups: 1A and 2A included patients who underwent computed tomography (CT) of the lacrimal ducts in the preoperative period according to the developed method and patients of subgroups 1B and 2B – according to the traditional algorithm. Statistical analysis was performed using the licensed program MedCalc (MedCalc Software bvba, Ostend, Belgium; 2017).
Results. In patients of subgroups 2A, 2B, and group 3 in the period of 1.5 months after surgery, local complications of the eyeball were recorded: epiphora during implant wearing, severe conjunctivitis, prolapse and displacement of the implant, granulation in the lower lacrimal duct, ectopia of the lower lacrimal point. No such complications were observed in patients of subgroups 1A and 1B. In patients of subgroups 1B, 2B, and group 3 in the early postoperative period were recorded varying degrees of swelling of the lower eyelid, as well as nosebleeds after removal of tampons. No such complications were observed in patients of subgroups 1A and 2A, and the difference between the groups was statistically significant (p <0.05).
Conclusion. CT of the lacrimal ducts and EEDCR according to the developed methods are effective and allow their combined use to avoid local complications from the nasal cavity and eyeball.
2. At’kova EL, Yartsev VD, Krakhovetskiy NN, Reznikova LV, Root AO. [Study of the peculiarities of the structure of the nasolacrimal duct orifice according to the data of multislice computed tomography]. Journal of radiology and nuclear medicine. 2018; 99(2):63-70. [in Russian]. DOI: https://doi.org/10.20862/0042-4676-2018-99-2-63-70
3. Kumar S, Mishra AK, Sethi A, Mallick A, Maggon N, Sharma H, Gupta A. Comparing Outcomes of the Standard Technique of Endoscopic DCR with Its Modifications: A Retrospective Analysis. Otolaryngol Head Neck Surg. 2019 Feb; 160(2):347-54. DOI: https://doi.org/10.1177/0194599818813123
4. Li EY, Wong ES, Wong AC, Yuen HK. Primary vs Secondary Endoscopic Dacryocystorhinostomy for Acute Dacryocystitis With Lacrimal Sac Abscess Formation: A Randomized Clinical Trial. JAMA Ophthalmol. 2017 Dec 01; 135(12):1361-66. DOI: https://doi.org/10.1001/jamaophthalmol.2017.4798
5. Feng YF, Cai JQ, Zhang JY, Han XH. A meta-analysis of primary dacryocystorhinostomy with and without silicone intubation. Can J Ophthalmol. 2011; 46(6):521-7. DOI: https://doi.org/10.1016/j.jcjo.2011.09.008
6. Madge S.N., Selva D. Intubation in routine dacryocystorhinostomy: why we do what we do. Clinical and Experimental Ophthalmology. 2009; 37: 620-3. DOI: https://doi.org/10.1111/j.1442-9071.2009.02094.x
7. Wu S, Xu T, Fan B, Xiao D. Endoscopic dacryocystorhinostomy with an otologic T-type ventilation tube in repeated revision cases. BMC Ophthalmol. 2017; 17(1):138. DOI: https://doi.org/10.1186/s12886-017-0539-7
8. Pakdel F. Silicone Intubation Does not Improve the Success of Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction. Journal of Ophthalmic and Vision Research. 2012; 7 (3):271-2. PMID: 23264872. URL: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3520599/
9. Ananth L, Hosamani P, Chary G. Efficacy of endonasal dacryocystorhinostomy, using ‘cold steel’ instruments without stenting, in treatment of distal nasolacrimal duct obstruction. J Laryngol Otol. 2011; 125(6):590-4. DOI: https://doi.org/10.1017/s002221511100017x
10. Chong KK, Lai FH, Ho M, Luk A, Wong BW, Young A. Randomized trial on silicone intubation in endoscopic mechanical dacryocystorhinostomy (SEND) for primary nasolacrimal duct obstruction. Ophthalmology. 2013;120(10):2139-45. DOI: https://doi.org/10.1016/j.ophtha.2013.02.036
11. Smirnov G, Tuomilehto H, Terasvirta M, Nuutinen J, Seppa J. Silicone tubing is not necessary after primary endoscopic dacryocystorhinostomy: a prospective randomized study. American Journal of Rhinology. 2008; 22(2):214-7. DOI: https://doi.org/10.2500/ajr.2006.20.2955
12. Unlu HH, Gunhan K, Baser EF, Songu M. Long-term results in endoscopic dacryocystorhinostomy: is intubation really required? Otolaryngology – Head and Neck Surgery. 2009; 140(4):589-95. DOI: https://doi.org/10.1016/j.otohns.2008.12.056
13. Cukurova I, Caner Mercan G, Cetinkaya E, Gumusssoy M, Soken H. Endoscopic dacryocystorhinostomy: outcomes using mucosal flap preserving technique. Eur Arch Otorhinolaryngol. 2013; 270(5):1661-6. DOI: https://doi.org/10.1007/s00405-012-2285-z
14. Mueller SK, Freitag SK, Lefebvre DR, Bleier BS. Endoscopic DCR using bipedicled interlacing mucosal flaps. The Laryngoscope. 2017; 128(4):794-7. DOI: https://doi.org/10.1002/lary.26730
15. Peng W, Tan B, Wang Y, Wang H, Wang Z, Liang X. A Modified Preserved Nasal and Lacrimal Flap Technique in Endoscopic Dacryocystorhinostomy. Sci Rep. 2017; 28;7(1):6809. DOI: https://doi.org/10.1038/s41598-017-07364-9
16. Ayoob M, Mahida K. Outcome and complications of endoscopic dacryocystorhinostomy without stenting. Pakistan journal of medical sciences. 2013; 29(5):1236. DOI: https://doi.org/10.12669/pjms.295.3393
17. Saratziotis A, Emanuelli E, Gouveris H, Babighian G. Endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction: creating a window with a drill without use of mucosal flaps. Acta Otolaryngol. 2009; 129(9):992-5. DOI: https://doi.org/10.1080/00016480802495396
18. Wu W, Cannon PS, Yan W, Tu Y, Selva D, Qu J. Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis. Eye (Lond). 2011; 25(6):746-53. DOI: https://doi.org/10.1038/eye.2011.44
19. Green R, Gohil R, Ross P. Mucosal and lacrimal flaps for endonasal dacryocystorhinostomy: a systematic review. Clin Otolaryngol. 2017; 42(3):514-20. DOI: https://doi.org/10.1177/0194599812447759
20. Dumansky YuV, Zabolotny DI, Boenko SK, Shlopov VG, Savchenko OA, Klimov ZT, et al. [Functional endoscopic rhinosurgery]. Donetsk:Nord-press; 2010: 202-6. [Іn Ukrainian]. URL: http://www.irbis-nbuv.gov.ua/cgi-bin/irbis_nbuv/cgiirbis_64.exe?Z21ID=&I21DBN=EC&P21DBN=EC&S21STN=1&S21REF=10&S21FMT=fullwebr&C21COM=S&S21CNR=20&S21P01=0&S21P02=0&S21P03=I=&S21COLORTERMS=1&S21STR=%D0%92%D0%90738296$
21. Zabolotnyi DI, Minaiev OO. [Chronic dacryocystitis: Сlinical and Radiological parallels]. Scientific Collection «InterConf». Science and practice: implementation to modern society. 2020 Dec; 2(38);913-22. [in Ukrainian] URL: https://interconf.top/documents/2020.12.16-18.pdf
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