The Results of Our External Dacryocystorhinostomy and Bicanalicular Silicone Tube Intubation Operation

Yıl 2007, Cilt: 14 Sayı: 3, 163 - 166, 01.06.2007

Mete Güler Özge Evren Tamer Demir Jülide Kurt

Öz

Purpose: To assess the results of external dacryocystorhinostomy and bicanalicular silicone tube intubation (EDSR+STI) operations in our patients with acquired nasolacrimal duct obstruction. Materials and Methods: A total of 80 EDSR+STI operations that were performed under general anaesthesia on 74 patients with acquired nasolacrimal duct obstruction aged 9 to 62 (median 36,9) were evaluated retrospectively. Results: Thirteen patients (17,5%) were male and 61 (82,5%) were female. Seventy-nine of the 80 operations were initial procedures and in these procedures 73 (91,25%) open passages were obtained. Median postoperative follow-up period was 7,4 months (3 to 32 months). One (1,25%) procedure was made for restoration of a complication of a patient who was operated in a different center and in this patient open passage was obtained as well. In six patients (7,5%) eyes passages were closed. Four of these patients who were younger than 50 years old were reoperated and in two of them (50%) open passages re-obtained. Overall in 76 (95%) of the 80 nasolacrimal duct obstruction the passages were open. In one (1,25%) eye cutaneous fistula was developed and was repaired successfully. In five (6,25%) eyes punctum erosion were observed. The most important postoperative early complaint epistaxis was seen in nine (11,25%) procedures. Conclusion: External DSR+STI is a safe and effective procedure and it may be performed as an initial operation in patients with acquired nasolacrimal duct obstruction Key words: External dacryocystorhinostomy, Silicone tube intubation

Anahtar Kelimeler

External dacryocystorhinostomy, Silicone tube intubation

Eksternal Dakriosistorinostomi ve Bikanaliküler Silikon Tüp Entübasyonu Cerrahisi Sonuçlarımız

Öz

Amaç: Edinsel nazolakrimal kanal tıkanıklığı olan hastalarımızda eksternal dakriosistorinostomi ve silikon tüp entübasyonu (EDSR+STE) cerrahilerinin sonuçlarını değerlendirmek. Gereç ve Yöntem: Yaşları 9 ile 62 (ortalama 36,9) arasındaki edinsel nazolakrimal kanal tıkanıklığı olan 74 hastaya genel anestezi altında yapılan toplam 80 EDSR+ STE cerrahisi retrospektif olarak değerlendirildi. Bulgular: On üç hasta (%17,5) erkek, 61 (%82,5) hasta kadın idi. Seksen cerrahinin 79' u ilk girişimdi ve bu cerrahilerden 73'ünde (%91,25) açık pasaj elde edildi. Cerrahi sonrası ortalama takip süresi 7,4 ay (3-32 ay) idi. Bir (%1,25) müdahale başka bir merkezde ameliyat olan hastanın komplikasyonunu düzeltmek amacıyla yapıldı ve bu hastada da açık pasaj edinildi. Altı (%7,5) gözde pasaj kapandı. Elli yaşından genç olan 4 hasta tekrar ameliyat edildi ve bunların 2' (%50) sinde yeniden açık pasaj edinildi. Sonuç olarak 80 nazolakrimal kanal tıkanıklığının 76' (%95) sında pasaj açık idi. Bir (%1,25) gözde cilt fistülü gelişti ve başarıyla onarıldı. Beş (%6,25) gözde punktum erozyonu izlendi. En önemli erken şikayet epistaksis 9 (%11,25) cerrahide izlendi. Sonuç: Eksternal DSR+STE cerrahisi güvenli, etkili bir yöntemdir ve edinsel nazolakrimal kanal tıkanıklıklarında ilk girişim olarak uygulanabilir. Anahtar kelimeler: Eksternal Dakriosistorinostomi, Silikon tüp entübasyonu

Anahtar Kelimeler

Eksternal Dakriosistorinostomi, Silikon tüp entübasyonu

Kaynakça

• Tien DR, Young D. Balloon Dilation of the Nasolacrimal Duct. J AAPOS 2005; 9: 465-7
• Sodhi PK, Pandey RM, Malik KPS. Experience with bicanalicular intubation of the lacrimal drainage apparatus combined with conventional external dacryocystorhinostomy. J Craniomaxillofac Surg 2003; 31: 187-90
• Tarbet KJ, Custer PL. External dacryocystorhinostomy. Surgical success, patient satisfaction and economic cost. Ophthalmology 1995;102:1065-70
• Toti A. Nuovo metodo conservatore di cura radicale delle suppurazioni croniche del sacco lacrimale (Dacriocistorinostomia). Clin. Mod. Firenze 1904; 10: 385.
• Dupuy-Dutemps, Bourguet. Note preliminaire sur un procede de dacryocystorhinostomie. Ann. Ocul. Par. 1920; 157: 445.
• Horix D, Struck HG. Long term patency rate of the external dacryocystorhinostomy. A retrospective study in the years 1991-2000 at the University Eye Hospital in Halle. Ophthalmologe 2004;101: 268-77
• Walland MJ, Rose GE. Factors affecting the success rate of open lacrimal surgery. Br J Ophthalmol 1994; 78: 888-91
• Rosen N, Sharir M, Moverman DC, Rosner M. Dacryocystorhinostomy with silicone tubes: Evaluation of 253 cases. Ophthal Surg. 1989; 20: 115–9.
• Shun- Shin GA, Thurairajan G. External dacryocystorhinostomy-an end of an era? Br J Ophthalmol 1997; 81: 716-7
• Watts P, Ram AR, Nair R, Williams H. Comparison of external dacryocystorhinostomy and 5-fluorouracil augmented endonasal laser dacryocystorhinostomy. A Retrospective review. Indian J Ophthalmol 2001; 49: 169- 72
• Sadiq SA, Hugkulstone CE, Jones NS, Downes RN. Endoscopic holmium: YAG laser dacryocystorhinostomy. Eye 1996;10:43-6
• Zilelioğlu G, Tekeli O, Uğurbaş SH, Akıner M, Aktürk T, Anadolu Y. Results of endoscopic endonasal non-laser dacryocystorhinostomy. Doc Ophthalmol 2002; 105: 57-62
• Deka A, Bhattacharjee K, Bhuyan SK, Barua CK, Bhattacharjee H, Khaund G. Effect of mitomycin C on ostium in dacryocystorhinostomy Clin Experiment Ophthalmol 2006; 34: 557–61.
• Birinci H, Acar E, Öğe İ, Öğe F. Dakriosistorinostomi ile birlikte bikanaliküler silikon tüp entübasyonu uygulaması. Türk Oftalmoloji Gazetesi 1999; 29: 298-301
• Argın A, Duman S, Örnek F. Dakriosistorinostomide silikon entübasyonun yeri. Mersin Üniversitesi Tıp Fakültesi Dergisi 2001; 3: 281-4
• Elwan S. A randomized study comparing DCR with and without excision of the posterior mucosal flap. Orbit 2003; 22: 7-13
• Serin D, Alagöz G, Karslıoğlu S, Çelebi S, Kükner Ş. External Dacryocystorhinostomy: Double-Flap Anastomosis or Excision of the Posterior Flaps? Ophthal Plast Reconstr Surg 2007; 23: 28-31.
• Ezra E, Restori M, Mannor GE, Rose GE. Ultrasonic assessment of rhinostomy size following external dacryocystorhinostomy. Br J Ophthalmol 1998; 82: 786–789.
• Linberg JV, Anderson RL, Busted RM, Barreras R. Study of intranasal ostium external dacryocystorhinostomy. Arch Ophthalmol 1982;100:1758–1762
• Caesar RH, Fernando G, Scott K, McNab AA. Scarring in external dacryocystorhinostomy: fact or fiction? Orbit 2005; 24: 83-6
• McNab AA, Simmie RJ. Effectiveness of local anaesthesia for external dacryocystorhinostomy. Clin Experiment Ophthalmol 2002; 30: 270-2
• Çiftçi F, Pocan S, Karadayı K, Gülecek O. Local versus general anesthesia for external dacryocystorhinostomy in young patients. Ophthalmol Plast Reconstr Surg 2005; 21: 201-6
• Erdöl H, Akyol N, İmamoğlu Hİ, Sözen E. Long-term follow-up of external dacryocystorhinostomy and the factors affecting its success. Orbit. 2005 ; 24: 99-102.