Advertisement

Resolving Perplexity: Comparison of Endoscopic Dacryocystorhinostomy With and Without Stent

  • Jasdeep MongaEmail author
  • Yojana Sharma
  • Girish Mishra
  • Mehul Patel
Original Article
  • 34 Downloads

Abstract

Endoscopic dacryocystorhinostomy (DCR) is an effective surgical procedure to treat nasolacrimal duct obstruction. This study was conducted with an aim of comparing the success rate between use of stent and without use of stent in endoscopic DCR. A prospective randomized study was conducted. Total 50 cases with signs of nasolacrimal duct blockage were included. The cases were randomly divided in two groups with 25 cases in each group. Group A cases underwent endoscopic DCR with stent and group B without stent. The follow up was till 12th week. Both subjective and objective outcomes were noted. By 12th week, only 8% cases had no relief of symptoms in group A while 92% cases of group A and all cases of group B had complete relief of symptoms. In objective outcome, by the 12th week, in group A 92% cases had full patency while in group B 100% cases had full patency. Overall complications in postoperative period were seen in 28% patients in group A and 12% patients in group B. In this study the surgical results of endoscopic DCR with or without stent came almost equal with no statistical difference in the success rate between stent group and non-stent group. Now that Endoscopic DCR without stent is equally effective and reduces cost, we recommend that the endoscopic DCR without stent should be preferred.

Keywords

Nasolacrimal duct Endoscopic dacryocystorhinostomy Stent 

Notes

Compliance with Ethical Standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

References

  1. 1.
    Paulsen F (2007) Pathophysiological aspects of PANDO, dacryolithiasis, dry eye, and punctum plug. In: Weber RK et al (eds) Atlas of lacrimal surgery, 15–28CrossRefGoogle Scholar
  2. 2.
    Griffiths JD (1991) Nasal catheter use in dacryocystorhinostomy. Ophthal Plast Reconstr Surg 7(3):177–186CrossRefGoogle Scholar
  3. 3.
    Zaman M, Babar TF, Saeed N (2003) A review of 120 cases of dacryocystorhinostomies (Dupuy Dutemps and Bourguet technique). J Ayub Med Coll Abbottabad 15(4):10–12PubMedGoogle Scholar
  4. 4.
    Mirza S, Jones N (2007) Laser assisted dacryocystorhinostomy. In: Weber RK et al (eds) Atlas of lacrimal surgery, 74CrossRefGoogle Scholar
  5. 5.
    Hartikainen J, Antila J, Varpula M, Puukka P, Seppä H, Grénman R (1998) Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy. Laryngoscope 108(12):1861–1866CrossRefGoogle Scholar
  6. 6.
    McDonogh M, Meiring JH (1989) Endoscopic transnasal dacryocystorhinostomy. J Laryngol Otol 103(6):585–587CrossRefGoogle Scholar
  7. 7.
    Sinha V, Gupta D, Prajapati B, More Y, Khandelwal P, Singh SN et al (2008) Endoscopic dacryocystorhinostomy with conventional instruments: results and advantages over external dacryocystorhinostomy. Indian J Otolaryngol Head Neck Surg 60(3):207–209CrossRefGoogle Scholar
  8. 8.
    Rice DH (1988) Endoscopic dacryocystorhinostomy: a cadaver study. Am J Rhinol 2(3):127–128CrossRefGoogle Scholar
  9. 9.
    Onerci M, Orhan M, Ogretmenoğlu O, Irkeç M (2000) Long-term results and reasons for failure of intranasal endoscopic dacryocystorhinostomy. Acta Otolaryngol 120(2):319–322CrossRefGoogle Scholar
  10. 10.
    Sadiq SA, Ohrlich S, Jones NS, Downes RN (1997) Endonasal laser dacryocystorhinostomy—medium term results. Br J Ophthalmol 81(12):1089–1092CrossRefGoogle Scholar
  11. 11.
    Vishwakarma R, Singh N, Ghosh R (2004) A study of 272 cases of endoscopic dacryocystorhinostomy. Indian J Otolaryngol Head Neck Surg 56(4):259–261PubMedPubMedCentralGoogle Scholar
  12. 12.
    Unlu HH, Toprak B, Aslan A, Guler C (2002) Comparison of surgical outcomes in primary endoscopic dacryocystorhinostomy with and without silicone intubation. Ann Otol Rhinol Laryngol 111(8):704–709CrossRefGoogle Scholar
  13. 13.
    Singhal SK, Bansal S, Dass A, Arya SK, Nagarkar NM (2005) Endoscopic Dacryocystorhinostomy without stent: analysis of 37 patients. Internal J Otolaryngol 4:1Google Scholar
  14. 14.
    Yigit O, Samancioglu M, Taskin U, Ceylan S, Eltutar K, Yener M (2007) External and endoscopic dacryocystorhinostomy in chronic dacryocystitis: comparison of results. Eur Arch Otorhinolaryngol 264(8):879–885CrossRefGoogle Scholar
  15. 15.
    Ramkrishnan VR, Hink EM, Durairaj VD (2007) Outcomes after endoscopic dacryocystorhinostomy without mucosal flap preservation. Am J Rhinol 21(6):753–757CrossRefGoogle Scholar
  16. 16.
    Massaro BM, Gonnering RS, Harris GJ (1990) Endonasal laser dacryocystorhinostomy: a new approach to nasolacrimal duct obstruction. Arch Ophthalmol 108(8):1172–1176CrossRefGoogle Scholar
  17. 17.
    Metson R, Woog JJ, Puliafito CA (1994) Endoscopic laser dacryocystorhinostomy. Laryngoscope 104(3):269–274CrossRefGoogle Scholar
  18. 18.
    Hofmann T, Lackner A, Muellner K, Luxenberger W, Wolf G (2003) Endolacrimal KTP laser–assisted dacryocystorhinostomy. Arch Otolaryngol-Head Neck Surg 129(3):329–332CrossRefGoogle Scholar
  19. 19.
    Nayak DR, Sathish KR, Shah P, Pujary K, Balakrishnan R (1999) Endoscopic dacryocystorhinostomy and retrograde nasolacrimal duct dilatation with cannulation: our experience. Indian J Otolaryngol Head Neck Surg 52(1):23–27PubMedPubMedCentralGoogle Scholar
  20. 20.
    Pittore B, Tan N, Salis G, Brennan PA, Puxeddu R (2010) Endoscopic transnasal dacryocystorhinostomy without stenting: results in 64 consecutive procedures. Acta Otorhinolaryngol Ital 30(6):294–298PubMedPubMedCentralGoogle Scholar
  21. 21.
    Jin HR, Yeon JY, Choi MY (2006) Endoscopic dacryocystorhinostomy: creation of a large marsupialized lacrimal sac. J Korean Med Sci 21(4):719–723CrossRefGoogle Scholar
  22. 22.
    Bernal-Sprelkelsen M, Alobid I, Ballesteros F et al (2007) Dacryocyatorhinostomy surgical technique. In: Weber RK, Keerl R et al (eds) Atlas of lacrimal surgery. Springer, Berlin, pp 61–68CrossRefGoogle Scholar
  23. 23.
    Gupta AK, Bansal S (2006) Primary endoscopic dacryocystorhinostomy in children: analysis of 18 patients. Int J Pediatr Otorhinolaryngol 70(7):1213–1217CrossRefGoogle Scholar
  24. 24.
    Walland MJ, Rose GE (1994) The effect of silicone intubation on failure and infection rates after dacryocystorhinostomy. Ophthalmic Surg 25:597–600PubMedGoogle Scholar
  25. 25.
    Allen K, Berlin AJ (1989) Dacryocystorhinostomy failure: association with nasolacrimal silicone intubation. Ophthalmic Surg 20:486–489Google Scholar
  26. 26.
    Singh M, Jain V, Gupta SC, Singh SP (2004) Intranasal endoscopic DCR (END-DCR) in cases of dacryocystitis. Indian J Otolaryngol Head Neck Surg 56(3):177–183PubMedPubMedCentralGoogle Scholar
  27. 27.
    Unlu HH, Gunhan K, Baser EF, Songu M (2009) Long-term results in endoscopic dacryocystorhinostomy: is intubation really required? Otolaryngol Head Neck Surg 140(4):589–595CrossRefGoogle Scholar
  28. 28.
    Smirnov G, Tuomilehto H, Teräsvirta M, Nuutinen J, Seppä J (2008) Silicone tubing is not necessary after primary endoscopic dacryocystorhinostomy: a prospective randomized study. Am J Rhinol 22(2):214–217CrossRefGoogle Scholar
  29. 29.
    Harvinder S, Rosalind S, Philip R (2008) Powered endoscopic dacryocystorhinostomy with mucosal flaps without stenting. Med J Malays 63(3):237–238Google Scholar
  30. 30.
    Longari F, Mobaraki PD, Ricci AL et al (2016) Endoscopic dacryocystorhinostomy with and without silicone intubation: 4 years retrospective study. Eur Arch Otorhinolaryngol 273(8):2079–2084CrossRefGoogle Scholar
  31. 31.
    Ben Simon GJ, Joseph J, Lee S et al (2005) External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Ophthalmology 112:1463–1468CrossRefGoogle Scholar
  32. 32.
    Tsirbas A, Davis G, Wormald PJ (2005) Revision dacryocystorhinostomy: a comparison of endoscopic and external techniques. Am J Rhinol 19:322–325CrossRefGoogle Scholar
  33. 33.
    Penttilä E, Smirnov G, Seppä J et al (2011) Mitomycin C in revision endoscopic dacryocystorhinostomy: a prospective randomized study. Am J Rhinol Allergy 25:425–428CrossRefGoogle Scholar

Copyright information

© Association of Otolaryngologists of India 2017

Authors and Affiliations

  1. 1.Department of ENTSGT Medical College, Hospital & Research InstituteGurugramIndia
  2. 2.Department of ENTShree Krishna Hospital and Pramukhswami Medical CollegeKaramsadIndia
  3. 3.ENT HospitalAnandIndia

Personalised recommendations