Comparison of different surgical methods in endonasal dacryocystorhinostomy

Abstract

Objective: The objective of this study is to compare three different techniques applied during dacryocystorhinostomy in terms of recurrence and operative times. Methods: Operative times and follow-up results of the patients who underwent endoscopic dacryocystorhinostomy surgery between January 2011 and April 2014 due to nasolacrimal duct occlusion were compared. Lacrimal sacs of the patients in Group 1 (n=15) were explored using gouge hammer and surrounding bony structures were dilated with diamond drilling instrument. Lacrimal sacs of the patients in Group 2 (n=11) were identified and dilated using Diamond drill. Lacrimal sacs of the patients in Group 3 (n=15), were found with the aid of a gouge hammer and enlarged using Smith-Kerrison punch forceps. Results: There was no significant difference between Groups 1 and 2 as for recurrence rates. However, recurrence rates in Group 3 were found to be higher compared to Groups 1 and 2. Operative times demonstrated significant differences among 3 groups, with at its highest and lowest operative times detected in Groups 1 and 2, respectively. Conclusion: With this study, it was concluded that exploration and identification of lacrimal sac using gouge hammer and expansion of the surrounding bony structure with diamond tipped drills during dacryocystorhinostomy is an improved method with relative shortness of the operative time and lower recurrence rates.

Keywords

• Nasolacrimal canal, dacryocystorhinostomy, epiphora, dacryocystitis

Endonazal dakriyosistorinostomide farklı cerrahi yöntemlerin karşılaştırılması

Öz

Amaç: Bu çalışmanın amacı, dakriyosistorinostomi cerrahisi sırasında uygulanan üç farklı tekniğin nüks ve süre açısından karşılaştırılmasıdır. Yöntem: Ocak 2011 - Nisan 2014 tarihleri arasında nazolakrimal kanal tıkanıklığı nedeniyle endoskopik dakriyosistorinostomi cerrahisi uygulanan hastaların cerrahi süreleri ve takip sonuçları karşılaştırıldı. Grup 1'deki hastaların (n=15) lakrimal kesesi guj-çekiç ile bulunup, etrafındaki kemik doku elmas tur ile genişletildi. Grup 2'deki hastaların (n=11) lakrimal kesesi sadece elmas tur ile bulunup genişletildi. Grup 3'teki hastaların (n=15) lakrimal keseleri guj-çekiç yardımıyla bulundu ve Smith-Kerrison punch forceps ile genişletildi. Bulgular: Nüks açısından Grup 1 ve Grup 2 arasında anlamlı farklılık yoktu. Buna karşılık Grup 3'teki nüks oranı, Grup 1 ve Grup 2'ye kıyasla anlamlı olarak daha yüksek bulundu. Ameliyat süresi her üç grupta da anlamlı farklılık gösterdi ve Grup 2'de en yüksek, Grup 3'te ise en düşük değerde idi. Sonuç: Bu çalışma, dakriyosistorinostomi cerrahisi sırasında lakrimal kesenin guj-çekiç ile bulunup, etrafındaki kemik dokunun elmas tur ile genişletildiği yöntemin cerrahi süresinin nispeten kısa olması yanında düşük nüks oranlarıyla iyi bir yöntem olduğu sonucuna ulaşılmıştır.

Anahtar Kelimeler

• Nazolakrimal kanal, dakriyosistorinostomi, epifora, dakriyosistit

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21. Please cite this article as: Ulusoy S, Erden M, Yüksel H, Ça¤lar E, Dinç ME, Dalgıç A. Comparison of different surgical methods in endonasal dacry
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