Chronic dacryocystitis, endonasal dacryocystorhinostomy, complications

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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.


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