Evaluation of Intranasal Ostium in External Dacryocystorhinostomy

Abstract

Objective: The investigation of factors affecting the dimension and configuration of the intranasal ostium in successful external dacryocystorhinostomy (DCR). Material and Methods: Fifty-one patients were enrolled within this study. During operation, dimensions of bone window were measured. In the postoperative sixth month, changes in bone window size were evaluated using spiral paranasal tomography, and the intranasal ostium was examined with nasal endoscopy. Results: There were 19 patients who underwent DCR and 32 patients who underwent DCR+silicone tube intubations (SI). The mean bone window size was 214.37 mm2 during operation and 214.87 mm2 after six months. The mean intranasal ostium size was measured as 51.42 mm2 for patients who had undergone DCR and 28.66 mm2 for the DCR+SI cases. The endoscopic appearance of the ostium was observed as oval or round for the DCR cases and in slit form for the DCR+SI cases. A multiple logistic regression model showed that silicon tube intubation posed an 11 times greater risk for configuration distortion in the intranasal ostium (p=0.0079). Conclusion: Postoperative intranasal ostium size has a relation with the intraoperative bone window size. The difference of mean intranasal ostium sizes of DCR and DCR+SI cases was not statistically significant. However, because SI gives rise to ostium configuration by triggering fibrosis, it should not be carried out unless absolutely necessary.

Keywords

• External dacryocystorhinostomy, intranasal ostium, rhinostomy, endonasal dacryocystorhinostomy

Evaluation of Intranasal Ostium in External Dacryocystorhinostomy

Öz

References

1. Zilelioğlu G, Uğurbaş SH, Anadolu Y, Akiner M, Aktürk T. Ad- junctive use of mitomycin C on endoscopic lacrimal surgery. Br J Ophthalmol 1998;82:63-6. [CrossRef]
2. McLean C, Cree IA, Rose GE. Rhinostomies: an open and shut case? Br J Ophthalmol 1999;83:1300-1. [CrossRef]
3. Erdöl H, Akyol N, Imamoglu HI, Sozen E. Long-term follow-up of external dacryocystorhinostomy and the factors affecting its suc- cess. Orbit 2005;24:99-102. [CrossRef]
4. Rosen N, Sharir M, Moverman DC, Rosner M. Dacryocystorhinos- tomy with silicone tubes: evaluation of 253 cases. Ophthalmic Surg 1989;20:115-9.
5. Tarbet KJ, Custer PL. External dacryocystorhinostomy. Surgical success, patient satisfaction, and economic cost. Ophthalmology 1995;102:1065-70.
6. Mc Lachlan DL, Shannon GM, Flanagan JC. Results of dac- ryocystorhinostomy: analysis re-operations. Ophthalmic Surg 1980;11:427-30.
7. Welham RAN, Wulc AE. Management of unsuccesful lacrimal sur- gery. Br J Ophthalmol 1987;71:152-7. [CrossRef]
8. Glatt HJ, Chan AC, Barrett L. Evaluation of dacryocystorhinos- tomy failure with computed tomography and computed tomo- graphic dacryocystography. Am J Ophthalmol 1991;12:431-6.

9. Linberg JV, Anderson RL, Bumsted RM, Barreas R. Study of intra- nasal ostium in external dacryocystorhinostomy. Arch Ophthal- mol 1982;100:1758-62.
10. Ezra E, Restori M, Mannor GE, Rose GE. Ultrasonic assessment of rhinostomy size following external dacryocystorhinostomy. Br J Ophthalmol 1998;82:786-9. [CrossRef]
11. You YA, Fang CT. Intraoperative mitomycin C in dacryocystorhi- nostomy. Ophthal Plast Reconstr Surg 2001;17:115-9. [CrossRef]
12. Yazici B, Yazici Z. Final nasolacrimal ostium after external dacryo- cystorhinostomy. Arch Ophthalmol 2003;121:76-80.
13. Hunt TK. Wound healing. In: Paparella MN, Shumrick DA, ed. Otolaryngology. Philadelphia: WB Saunders Co;1973. p. 616.
14. Huang HS. A comparison between dacryocystorhinostomy and nasolacrimal duct trephination. Chin J Ophthal 1998;34:7.
15. Kao SC, Liao CL, Tseng JH, Chen MS, Hou PK. Dacryocysto- rhinostomy with intraoperative mitomycin C. Ophthalmology 1997;104:86-91.
16. Walland MJ, Rose GE. The effect of silicone intubation on fail- ure and infection rates after dacryocystorhinostomy. Ophthalmic Surg 1994;25:597-600.
17. Özay S, Bakbak B, Önder F. Eksternal dakriyosistorinostomide si- likon tüp entübasyonu endikasyonları. MN Oftalmol 2005;12:152-5.
18. Allen K, Berlin AJ. Dacryocystorhinostomy failure: association with nasolacrimal silicone intubation. Ophthalmic Surg 1989;20:486-9.
19. Yaman A, Koç T, Arıkan G, Söylev MF. Eksternal dakriyosistori- nostomide cerrahi farklılıkların karşılaştırılması. MN Oftalmol 2008;15:53-6.
20. Evereklioğlu C, Gündüz A, Er H. Silikon tüplü ve silikon tüpsüz eksternal dakriyosistorinostominin karşılaştırmalı sonuçları. MN Oftalmol 2000;7:167-9.