Babu A R, Sandhya D, Amulya T M, Tharunika S
Department of ENT, Head and Neck surgery, JSS Medical College, JSS Academy of Higher education and Research (JSSAHER), Mysuru, 570004 Karnataka India.
Indian J Otolaryngol Head Neck Surg. 2024 Oct;76(5):4575-4579. doi: 10.1007/s12070-024-04925-z. Epub 2024 Jul 25.
Dacryocystorhinostomy (DCR) stands as an essential surgical procedure for addressing the persistent challenge of dacryocystitis-a condition marked by inflammation of the lacrimal sac due to nasolacrimal duct obstruction. A hospital-based retrospective study was conducted in a tertiary care hospital, spanning the years 2018 to 2023, involving 34 patients who underwent Endoscopic Dacryocystorhinostomy. The study involved the examination of their clinical presentations, surgical techniques employed, and resulting outcomes along with causes of failure. Our study included 34 patients who had presented with persistent watering of eyes. The maximum number of cases was in the age group of 46-60 years (38%), with a minimum age of 7 years and a maximum age of 68 years. Among those 34 patients, 5 underwent a revision DCR. Fifteen patients underwent stenting. Thirteen of the fifteen patients, who underwent stenting came for regular postoperative follow up and stent removal was done 6 to 8 weeks later. The two patients who were lost to follow-up presented after 4 years of their initial surgery with persistent symptoms. The success rate of endoscopic DCR was 94% in our study. Endoscopic Dacryocystorhinostomy has emerged as a practical solution for addressing nasolacrimal duct obstruction. Despite numerous surgical modifications documented over time, the endoscopic DCR technique consistently demonstrates excellent outcomes with minimal patient morbidity. This study underscores the significance of thorough preoperative assessment, making informed decisions regarding stenting during both the preoperative and intraoperative period, employing proper surgical techniques, and recognizing the importance of regular post-operative follow-up.
泪囊鼻腔造口术(DCR)是治疗泪囊炎这一持续性挑战的重要外科手术。泪囊炎是一种因鼻泪管阻塞导致泪囊发炎的病症。在一家三级护理医院进行了一项基于医院的回顾性研究,研究时间跨度为2018年至2023年,涉及34例行内镜下泪囊鼻腔造口术的患者。该研究包括对他们的临床表现、采用的手术技术、手术结果以及失败原因进行检查。我们的研究纳入了34例有持续性流泪症状的患者。病例数最多的年龄组为46 - 60岁(38%),最小年龄为7岁,最大年龄为68岁。在这34例患者中,5例行泪囊鼻腔造口修复术。15例患者置入了支架。接受支架置入的15例患者中有13例进行了定期术后随访,并在6至8周后取出了支架。2例失访患者在初次手术后4年出现持续症状。在我们的研究中,内镜下泪囊鼻腔造口术的成功率为94%。内镜下泪囊鼻腔造口术已成为解决鼻泪管阻塞的一种切实可行的方法。尽管多年来记录了许多手术改良方法,但内镜下泪囊鼻腔造口术技术始终显示出极佳的效果,且患者并发症极少。本研究强调了全面术前评估的重要性,在术前和术中就支架置入做出明智决策,采用恰当的手术技术,以及认识到定期术后随访的重要性。