Research Article
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Comparison of External Dacryocystorhinostomy and Transcanalicular Multidiod Laser Dacryocystorhinostomy Results in Patients with Acquired Nasolacrimal Duct Obstruction

Year 2017, Volume: 1 Issue: 2, 67 - 71, 15.07.2017
https://doi.org/10.30565/medalanya.304560

Abstract

Aim:
Comparison of external dacryocystorhinostomy (DSR) and transcanalicular
multidiod laser dacryocystorhinostomy (TK-DSR) results in acquired nasolacrimal
duct obstruction cases.


Methods:
Data of patients diagnosed with acquired nasolacrimal duct obstruction and
operated were retrospectively screened. The results of external DSR surgeries
in 49 eyes of 47 patients and TK-DSR surgeries in 35 eyes of 34 patients were
compared. Patients' nasolacrimal passageway clearance was checked on
postoperative tenth day, and later on the first, third, sixth and twelfth
months.


Results: In
our study, surgical success rate determined at the twelfth month was 65.3% in
TK-DSR cases and 86.1% in external DSR cases. Mean operation duration was 53.02
± 5.04 minutes in the external DSR group and 22.62 ± 3.72 minutes in TK-DSR
group. In TK-DSR group, nasal synechia was seen in 6 patients (17.1%), concha
burn in 2 patients (5.7%) and canalicular occlusion in 1 patient (2.8%); while
hemorrhage was observed in 16 patients (32.6%) and skin fistulae developed in 2
patients (4.1%) in external DSR group.











Conclusion:
Despite advantages of TK-DSR, such as shortened operation time, less bleeding,
no need for skin incision, and less damage to the lacrimal pump system,
surgical success rates seem to be higher in external DSR. Appropriate surgical
technique should be applied to appropriate patients considering the advantages
of surgical techniques and success rates.
.

References

  • 1. Maden A Dakriosistorinostomi in: Oküloplastik cerrahi; Punto Yayın, İzmir, 1995;289.
  • 2. Can İ, Gultan E, İnan Y, Kural G. Dakriosistorinostomide 500 operasyonun değerlendirilmesi. T Klin Oftalmoloji. 1995;4:59-62.
  • 3. Erdol H, Akyol N, İmamoğlu HI, Sozen E. Long-term followw-up of external dacryocystorhinostomy and the factors, affecting its success. Orbit. 2005;24:99-102.
  • 4. Bilgin LK. Lakrimal cerrahide lazer. In: Turk oftalmoloji derneği yayınları no:1, Okuloplastik Cerrahi. Bursa, Fikret Ozsan Matbaası; 2003;1560-65.
  • 5. Zor KR, Demir ND, Aksoy AH, Önder AF, Aksoy F. Transkanaliküler Multidiod Dakriosistorinostomi ve Eksternal Dakriosistorinostomi Cerrahilerinin Sonuçları. Turk J Ophthalmol. 2014;44:31-34.
  • 6. Alanon Fernandez FJ, Alanon Fernandez MA, Martinez Fernandez A, Cardenas Lara M. Transcanalicular dacryocystorhinostomy by diode laser. Arch Soc Esp Oftalmol. 2004;79:325-30.
  • 7. Henson RD, Henson RG Jr, Cruz HC Jr, Comora JG. Use of the diod laser with intraoperative mitomycin C in endocanalicular laser dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 2007;23:134-37.
  • 8. Jose Maeso Riera, Maria Teresa Sellares Fabres. Transcanalicular diode laser dacryocystorhinostomy: technical variations and results. Acta Otorhinolaringol Esp. 2007;58:10-15.
  • 9. Toti A. Nuovo metodo conservatore dicura radicale dele supporazioni cronide del sacco lacrimale. Clin mod Firenze. 1904;10:385-89.
  • 10.Duputy- Dutemps L. Bourguet. Procede plastique de dacryocystorhinostomie et se resultants. Ann Ocul. 1921;158:241-61. 11.Aytek M. Göz yaşı drenaj sisteminin dünü bugünü. T Oft. Gaz 1991;23:83-86.
  • 12-Massaro BM, Gommering RS, Harris GJ. Endonasal laser dacryocystorhinostomy a new approach to nasolacrimal duct obstruction Arch. Ophtalmolojy 1990;108:1172-76.
  • 13. Reifler DM. Results of endoscopik laser assisted dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 1993;9:231-36.
  • 14. Luomanen M, Rauhamaa-Makinen R, Meurman JH, Kosloff T, Tiitta O. Healing of rat mouth mucosa after irradiation with CO2, Nd:YAG, and CO2-Nd: YAG combination lasers. Scand J Dent Res. 1994;102:223-38.
  • 15. Eloy P, Trussart C, Jouzdani E, Collet S, Rombaux P, Bertrand B. Transcanalicular diode laser assisted dacryocystorhinostomy. Acta Otorhinolaryngol Belg. 2000;54:157-63.
  • 16. Yazıcı B, Akova B. Simultaneous bilateral external dacryocystorhinostomy. Acta Ophthalmol . 2007;12:654-58.
  • 17. Haefliger IO, Piffaretti JM. Lacrimal drainage system endoscopic examination and surgery through the lacrimal punctum. Klin Monatsbl Augenheilkd 2001;218:384-87.
  • 18. Hekimhan P, Çelikoyar M, Göker S, Küçümser Y, Yılmaz Ö. Endoskopik Lazer Dakriyosistorinostomi. T Oft Gaz. 2002;32:332-36.
  • 19. Yılmaz T, Yılmaz A, Mert M, Taşkapılı M. Endoskopik Lazer Dakriosistorinostomi Sonuçlarımız. İstanbul Med J. 2013;14:102-5.
  • 20-Drnovsek-Olup B, Beltram M. Transcanalicular diode laser-assisted dacryocystorhinostomy. Indian J Ophthalmol 2010;58:213-17.
  • 21. Tripathi A, Lesser TH, O’Donnell NP, White S. Local anaesthetic endonasal endoscopic laser dacryocystorhinostomy: analysis of patients’ acceptability and various factors affecting the success of this procedure. Eye 2002;16:146-49.
  • 22. Rebeiz EE, Shapshay SM, Bowlds JH, Pankratov MM. Anatomic guidelines for dacryocystorhinostomy. Laryngoscope 1992;102;1181-84.

Edinsel Nazolakrimal Kanal Tıkanıklığı Olan Olgularda Eksternal Dakriosistorinostomi Ve Transkanalikuler Multidiod Lazer Dakriosistorinostomi Sonuçlarının Karşılaştırılması

Year 2017, Volume: 1 Issue: 2, 67 - 71, 15.07.2017
https://doi.org/10.30565/medalanya.304560

Abstract

Amaç:
Edinsel nazolakrimal kanal tıkanıklığı olan olgularda eksternal
dakriyosistorinostomi(DSR)  ve
transkanalikuler multidiod lazer dakriyosistorinostomi(TK-DSR) sonuçlarının
karşılaştırılması.


Yöntemler:
Edinsel nazolakrimal kanal tıkanıklığı tanısı konulan ve opere edilen
hastaların verileri retrospektif olarak tarandı. 47 hastanın 49 gözüne yapılan
eksternal DSR ameliyatları ile 34 hastanın 35 gözüne yapılan TK-DSR
ameliyatlarının sonuçları karşılaştırıldı. Hastaların nazolakrimal pasaj
açıklığı postoperatif 10. gün, 1, 3, 6 ve 12.aylarda kontrol edildi.           


Bulgular:
Çalışmamızda 12. ayda saptanan cerrahi başarı oranı TK-DSR olgularında % 65,3,
eksternal DSR olgularında % 86,1 idi. Ortalama ameliyat süresi eksternal DSR
grubunda 53,02±5,04 dakika, TK- DSR grubunda 22,62±3,72 dakikaydı. TK- DSR
grubunda 6 hastada (%17.1) nasal sineşi, 2 hastada (%5.7) konka yanığı, 1
hastada (%2.8) kanalikül oklüzyonu komplikasyon olarak görülürken, eksternal
DSR grubunda 16 hastada (%32.6) kanama, 2 hastada (%4.1) cilde fistül gelişti.












Sonuç: TK-
DSR operasyon süresinin kısalığı, kanamanın daha az olması, cilt insizyonuna
gerek kalmaması ve lakrimal pompa sisteminin daha az zarar görmesi gibi
avantajları olmasına karşın cerrahi başarı oranları eksternal DSR’de daha yüksek
görünmektedir. Cerrahi teknik üstünlükleri ve başarı oranları göz önünde
bulundurularak uygun hastalarda uygun cerrahi teknik uygulanmalıdır.

References

  • 1. Maden A Dakriosistorinostomi in: Oküloplastik cerrahi; Punto Yayın, İzmir, 1995;289.
  • 2. Can İ, Gultan E, İnan Y, Kural G. Dakriosistorinostomide 500 operasyonun değerlendirilmesi. T Klin Oftalmoloji. 1995;4:59-62.
  • 3. Erdol H, Akyol N, İmamoğlu HI, Sozen E. Long-term followw-up of external dacryocystorhinostomy and the factors, affecting its success. Orbit. 2005;24:99-102.
  • 4. Bilgin LK. Lakrimal cerrahide lazer. In: Turk oftalmoloji derneği yayınları no:1, Okuloplastik Cerrahi. Bursa, Fikret Ozsan Matbaası; 2003;1560-65.
  • 5. Zor KR, Demir ND, Aksoy AH, Önder AF, Aksoy F. Transkanaliküler Multidiod Dakriosistorinostomi ve Eksternal Dakriosistorinostomi Cerrahilerinin Sonuçları. Turk J Ophthalmol. 2014;44:31-34.
  • 6. Alanon Fernandez FJ, Alanon Fernandez MA, Martinez Fernandez A, Cardenas Lara M. Transcanalicular dacryocystorhinostomy by diode laser. Arch Soc Esp Oftalmol. 2004;79:325-30.
  • 7. Henson RD, Henson RG Jr, Cruz HC Jr, Comora JG. Use of the diod laser with intraoperative mitomycin C in endocanalicular laser dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 2007;23:134-37.
  • 8. Jose Maeso Riera, Maria Teresa Sellares Fabres. Transcanalicular diode laser dacryocystorhinostomy: technical variations and results. Acta Otorhinolaringol Esp. 2007;58:10-15.
  • 9. Toti A. Nuovo metodo conservatore dicura radicale dele supporazioni cronide del sacco lacrimale. Clin mod Firenze. 1904;10:385-89.
  • 10.Duputy- Dutemps L. Bourguet. Procede plastique de dacryocystorhinostomie et se resultants. Ann Ocul. 1921;158:241-61. 11.Aytek M. Göz yaşı drenaj sisteminin dünü bugünü. T Oft. Gaz 1991;23:83-86.
  • 12-Massaro BM, Gommering RS, Harris GJ. Endonasal laser dacryocystorhinostomy a new approach to nasolacrimal duct obstruction Arch. Ophtalmolojy 1990;108:1172-76.
  • 13. Reifler DM. Results of endoscopik laser assisted dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 1993;9:231-36.
  • 14. Luomanen M, Rauhamaa-Makinen R, Meurman JH, Kosloff T, Tiitta O. Healing of rat mouth mucosa after irradiation with CO2, Nd:YAG, and CO2-Nd: YAG combination lasers. Scand J Dent Res. 1994;102:223-38.
  • 15. Eloy P, Trussart C, Jouzdani E, Collet S, Rombaux P, Bertrand B. Transcanalicular diode laser assisted dacryocystorhinostomy. Acta Otorhinolaryngol Belg. 2000;54:157-63.
  • 16. Yazıcı B, Akova B. Simultaneous bilateral external dacryocystorhinostomy. Acta Ophthalmol . 2007;12:654-58.
  • 17. Haefliger IO, Piffaretti JM. Lacrimal drainage system endoscopic examination and surgery through the lacrimal punctum. Klin Monatsbl Augenheilkd 2001;218:384-87.
  • 18. Hekimhan P, Çelikoyar M, Göker S, Küçümser Y, Yılmaz Ö. Endoskopik Lazer Dakriyosistorinostomi. T Oft Gaz. 2002;32:332-36.
  • 19. Yılmaz T, Yılmaz A, Mert M, Taşkapılı M. Endoskopik Lazer Dakriosistorinostomi Sonuçlarımız. İstanbul Med J. 2013;14:102-5.
  • 20-Drnovsek-Olup B, Beltram M. Transcanalicular diode laser-assisted dacryocystorhinostomy. Indian J Ophthalmol 2010;58:213-17.
  • 21. Tripathi A, Lesser TH, O’Donnell NP, White S. Local anaesthetic endonasal endoscopic laser dacryocystorhinostomy: analysis of patients’ acceptability and various factors affecting the success of this procedure. Eye 2002;16:146-49.
  • 22. Rebeiz EE, Shapshay SM, Bowlds JH, Pankratov MM. Anatomic guidelines for dacryocystorhinostomy. Laryngoscope 1992;102;1181-84.
There are 21 citations in total.

Details

Primary Language Turkish
Subjects Surgery
Journal Section Research Article
Authors

Özgür Eroğul

Leyla Eryiğit Eroğul This is me

Mustafa Doğan

Onur Polat This is me

Aytuğ Buyruk

Publication Date July 15, 2017
Submission Date April 8, 2017
Acceptance Date May 21, 2017
Published in Issue Year 2017 Volume: 1 Issue: 2

Cite

Vancouver Eroğul Ö, Eryiğit Eroğul L, Doğan M, Polat O, Buyruk A. Edinsel Nazolakrimal Kanal Tıkanıklığı Olan Olgularda Eksternal Dakriosistorinostomi Ve Transkanalikuler Multidiod Lazer Dakriosistorinostomi Sonuçlarının Karşılaştırılması. Acta Med. Alanya. 2017;1(2):67-71.

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