An International Journal Clinical Rhinology

Register      Login

VOLUME 10 , ISSUE 3 ( 2017 ) > List of Articles

ORIGINAL ARTICLE

Clinical Study on Prognostic Indicators of Endonasal Dacryocystorhinostomy

PSN Murthy, Sudhakararao Madala, Ravikiran Potluri, Venkata DP Chodavarapu, Satishchandra Tripuraneni

Keywords : Dacryocystorhinostomy, Endonasal, Prognosis, Surgical

Citation Information : Murthy P, Madala S, Potluri R, Chodavarapu VD, Tripuraneni S. Clinical Study on Prognostic Indicators of Endonasal Dacryocystorhinostomy. Clin Rhinol An Int J 2017; 10 (3):103-106.

DOI: 10.5005/jp-journals-10013-1318

License: CC BY-ND 3.0

Published Online: 00-12-2017

Copyright Statement:  Copyright © 2017; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Aim: To assess various preoperative and peroperative clinical findings in endonasal dacryocystorhinostomy (DCR) as prognostic indicators of the surgical outcome. Materials and methods: A prospective study of 25 cases of chronic dacryocystitis with epiphora. All the patients were divided into two groups based on the presence or absence of medial canthal swelling with regurgitation of mucopus on finger pressure over medial canthus. Other factors included duration of epiphora, associated nasal problems, condition of the bone, sac wall, and lumen of the sac during surgery. Results: Out of 14 patients with medial canthal swelling (group I), all were successful on the table with free flow of saline, but one patient developed symptoms on 6 months follow-up and that was treated as failure. Out of 11 patients without medial canthal swelling, five were successful with free flow of saline on the table and six were unsuccessful because of tight or absent flow with regurgitation. Conclusion: Presence of medial canthal swelling and regurgitation of mucopus on digital pressure over medial canthus is a good prognostic indicator for a favorable surgical outcome. In patients without medial canthal swelling, we need to rely on syringing or dacryocystogram. Early intervention gives good results.


PDF Share
  1. Thomas R, Thomas S, Braganza A, Muliyil J. Evaluation of the role of syringing prior to cataract surgery. Indian J Ophthalmol 1997;45(4):211-214.
  2. Sekhar GC. Practical approach to a patient with epiphora. Indian J Ophthalmol 1994 Sep;42(3):157-161.
  3. Ben Simon GJ, Joseph J, Lee S, Schwarcz RM, McCann JD, Goldberg RA. External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Ophthalmology 2005 Aug;112(8):1463-1468.
  4. Mak ST, Io IY, Wong AC. Prognostic factors for outcome of endoscopic dacryocystorhinostomy in patients with primary acquired nasolacrimal duct obstruction. Graefes Arch Clin Exp Ophthalmol 2013 May;251(5):1361-1367.
  5. Ji QS, Zhong JX, Tu YH, Wu WC. New mucosal flap modification for endonasal endoscopic dacryocystorhinostomy in Asians. Int J Ophthalmol 2012 Dec;5(6):704-707.
  6. Moscato EE, Dolmetsch AM, Silkiss RZ, Seiff SR. Silicone intubation for the treatment of epiphora in adults with presumed functional nasolacrimal duct obstruction. Ophthal Plast Reconstr Surg 2012 Jan-Feb;28(1):35-39.
  7. Kne.evi. M, Stojkovi. M, Jovanovi. M, Stankovi. Z, Ra.i. DM. A 7-year prospective study of routine histopathological evaluation of the lacrimal sac wall incisional biopsy specimens obtained during external dacryocystorhinostomy in adults and a review of the literature. Med Oncol 2012 Mar;29(1):396-400.
  8. Codere F, Denton P, Corona J. Endonasal dacryocystorhinostomy: a modified technique with preservation of the nasal and lacrimal mucosa. Ophthal Plast Reconstr Surg 2010 May- Jun;26(3):161-164.
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.