Dogruya Suzan, Kayikcioglu Ömer Can, Kayikcioglu Özcan Rasim
Ophthalmology, Uşak University, Uşak, TUR.
Ophthalmology, Başkent University, İzmir, TUR.
Cureus. 2025 Aug 16;17(8):e90230. doi: 10.7759/cureus.90230. eCollection 2025 Aug.
Background External dacryocystorhinostomy (Ex-DCR) is a widely used surgical procedure for nasolacrimal duct obstruction, but its success may be influenced by coexisting nasal pathologies. Preoperative evaluation with paranasal sinus computed tomography (CT) can assist in surgical planning and decision-making. Purpose To identify nasal pathologies in patients who underwent Ex-DCR with bi-canalicular silicone tube intubation for dacryostenosis by reviewing their paranasal sinus CT scans and to evaluate the impact of these pathologies on surgical success. Method We retrospectively analyzed 78 patients with paranasal sinus CT. Nine patients underwent bilateral operations. Patients with primary acquired chronic dacryocystitis (PACD) and revision external dacryocystorhinostomy (rE-DCR) were included in the study. All patients underwent Ex-DCR with silicone tube intubation. Anatomic success was defined as the patency of the lacrimal passage after the removal of silicone tube six months after tube intubation. The study investigated septal deviation, concha bullosa, inferior concha hypertrophy, and sinus inflammation. Results The mean age of the patients was 58.39±11.67 years, with 11 men (14.1%) and 67 women (85.9%). Eighty (92%) patients had PACD and seven (8%) patients had rE-DCR. The mean follow-up period was 2.45±2.14 years. Among these, no pathology was detected in 26 patients (29.9%). Fifty-five (90%) of 61 patients with nasal pathology had anatomical success, but in six patients, no success was achieved. There was no statistically significant difference in anatomical success between patients with and without nasal pathologies (p>0.05). There was no significant difference in anatomical success between patients with PACD and rE-DCR (p=0.09). Conclusion Ex-DCR with bi-canalicular silicone intubation remains a safe and effective treatment for nasolacrimal duct obstruction, even in the presence of common nasal pathologies. While preoperative CT can be informative, these structural nasal findings do not appear to compromise surgical success in most cases.
外路泪囊鼻腔吻合术（Ex-DCR）是治疗鼻泪管阻塞的一种广泛应用的外科手术，但其成功率可能会受到并存的鼻腔病变的影响。术前进行鼻窦计算机断层扫描（CT）评估有助于手术规划和决策。目的：通过回顾接受Ex-DCR联合双泪小管硅胶管插管治疗泪道狭窄患者的鼻窦CT扫描，确定鼻腔病变，并评估这些病变对手术成功率的影响。方法：我们回顾性分析了78例鼻窦CT患者。9例患者接受了双侧手术。纳入原发性获得性慢性泪囊炎（PACD）和翻修外路泪囊鼻腔吻合术（rE-DCR）患者。所有患者均接受Ex-DCR联合硅胶管插管。解剖学成功定义为插管6个月后取出硅胶管时泪道通畅。该研究调查了鼻中隔偏曲、泡性鼻甲、下鼻甲肥大和鼻窦炎症。结果：患者的平均年龄为58.39±11.67岁，其中男性11例（14.1%），女性67例（85.9%）。80例（92%）患者患有PACD，7例（8%）患者患有rE-DCR。平均随访期为2.45±2.14年。其中，26例患者（29.9%）未检测到病变。61例有鼻腔病变的患者中有55例（90%）获得了解剖学成功，但有6例未成功。有鼻腔病变和无鼻腔病变的患者在解剖学成功方面无统计学显著差异（p>0.05）。PACD和rE-DCR患者在解剖学成功方面无显著差异（p=0.09）。结论：即使存在常见的鼻腔病变，Ex-DCR联合双泪小管硅胶管插管仍然是治疗鼻泪管阻塞的一种安全有效的方法。虽然术前CT可能提供有用信息，但这些鼻腔结构异常在大多数情况下似乎并不影响手术成功率。
