Browsing by Subject "Dacryocystorhinostomy"
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Item Endoscopic dacryocystorhinostomy without stents(2000) Ünlü H.H.; Öztürk F.; Mutlu C.; Ilker S.S.; Tarhan S.Objective: The aim of this study is to present our endoscopic DCR operation method without the use of silicone tubing and our results on the patients suffering from chronic epiphora with postsaccal stenosis. Methods: Endoscopic dacryocystorhinostomy operations were performed to 21 sides of 18 patients who had chronic epiphora. No silicone tubing was used in any of the cases. In the postoperative healing period, the rhinostomy opening was maintained with frequent removal of nasal debris and using eyedrops. The patients were evaluated by fluoresceine test and endoscopic controls. Results: Symptomatic improvement was achieved in 19 out of 21 sides of the patients (90.5%) and the results were confirmed by the fluoresceine test under endoscopic control. Conclusion: Our results of 21 sides of 18 cases underwent primary DCR without stents are as successful as those reported in the literature and the technique seems to be promising. Copyright (C) 2000 Elsevier Science Ireland Ltd.Item Comparison of surgical outcomes in primary endoscopic dacryocystorhinostomy with and without silicone intubation(2002) Unlu H.H.; Toprak B.; Aslan A.; Guler C.The surgical outcome of endoscopic endonasal dacryocystorhinostomy was analyzed in 30 cases of postsaccal stenosis. Intubation with silicone tubing was used in 14 cases (46.7%) and not used in 16 cases (53.3%). Surgical success was evaluated subjectively and objectively. The patients' complaints were improved in 85.7% of cases in the intubation group, and in 81.3% of the group in which no stent was used. Postoperative endoscopic examinations revealed that the rhinostomy opening was visible in 11 cases without intubation (68.8%) and 9 cases with intubation (64.3%). Six patients in the intubation group (42.9%) had granulation tissue at the rhinostomy site. Four patients (28.6%) had complaints regarding the intubation. Considering the similar surgical success rates, and the granulation formation, patient discomfort, and cost related to intubation, we recommend endoscopic dacryocystorhinostomy without intubation as the treatment of choice in cases of chronic epiphora due to postsaccal stenosis of the lacrimal canal.Item Long-term results in endoscopic dacryocystorhinostomy: Is intubation really required?(2009) Unlu H.H.; Gunhan K.; Baser E.F.; Songu M.Objective: The long-term (median follow-up eight years) results of endoscopic dacryocystorhinostomy approach and silicone intubation were evaluated by various aspects. Study Design: Case series with planned data collection of 38 procedures for postsaccal stenosis were analyzed. Subjects and Methods: Silicone intubation was not used in 19 of the randomly selected procedures. Anatomical and functional surgical success was evaluated subjectively and objectively. Results: The patients' complaints improved in 84.2 percent of eyes in the intubation group, and in 94.7 percent of the group without intubation, with a mean follow-up of 112 and 96 months after surgery, respectively. Postoperative endoscopic examinations revealed that the rhinostomy opening was visible in 17 sides with intubation (89.5%) and 18 sides without intubation (94.7%). Conclusions: Considering the similar surgical success rates, and disadvantageous factors such as granulation formation, patient discomfort, and cost related to intubation, we recommend endoscopic dacryocystorhinostomy without intubation as the treatment of choice in cases of chronic epiphora due to postsaccal stenosis of the lacrimal drainage system. © 2009 American Academy of Otolaryngology-Head and Neck Surgery Foundation.Item Surgical anatomy of the nasolacrimal duct on the lateral nasal wall as revealed by serial dissections(2010) Tatlisumak E.; Aslan A.; Cömert A.; Ozlugedik S.; Acar H.I.; Tekdemir I.The anatomy of the nasolacrimal duct (NLD) in relation with the lateral nasal wall was studied in 15 half-heads of human adult cadavers by serial photographs of the dissection of the lateral nasal wall. The aim of the study was to determine the intranasal anatomical relationships of the NLD with the lateral nasal wall for surgical reference during endoscopic dacryocystorhinostomy. Following removal of the nasal mucosa anterior to the uncinate process, the exposed bone was removed by drilling. The entire NLD was exposed intranasally. The relationships of the NLD with the maxillary sinus ostium and anterior nasal spine were determined, and the length of the NLD was measured. The morphology of the NLD opening was observed, and its distance from several landmarks were measured. There were three types of intranasal orifice: pin-point, triangular and slit-like. The NLD is located, on average, 24.6 ± 3.56 mm posterior to the anterior nasal spine. The nearest distances between the opening of the NLD and the nasal floor and between the opening of the NLD and the most anterior attachment of the inferior nasal concha were 13.7 ± 3.15 and 14.3 ± 2.05 mm, respectively. The length of the NLD was 21.9 ± 2.03 mm on average. The nearest distances between the NLD and the maxillary sinus ostium was 3.9 ± 0.88 mm. Cadaver dissections and the photographs of the fine dissections provide a more accurate description of the lateral nasal wall anatomy. These data provide valuable anatomical information to the surgeon performing endonasal dacryocystorhinostomy. © 2009 Japanese Association of Anatomists.Item Chronic inflammation: A poor prognostic factor for endoscopic dacryocystorhinostomy(2012) Özer Ö.; Eskiizmir G.; Ünlü H.; Işisaǧ A.; Asian A.Endoscopic endonasal dacryocystorhinostomy (En-DCR) success can be affected by many factors. In this study, we aimed to determine the effect of chronic inflammation on the surgical outcome of En-DCR. A series of 25 primary En-DCR cases and their lacrimal sac specimens were involved in the study. The surgical outcomes were assessed subjectively (satisfied and unsatisfied) and objectively (successful and unsuccessful). All the specimens were examined for the chronic inflammation related histopathological features (inflammatory cell infiltration, fibrosis and capillary proliferation) and graded according to their severity. Moreover, a "chronic inflammation score" was established to determine the intensity of chronic inflammation using the grade of histopathological features. A quantitative and statistical analysis of histopathological features and chronic inflammation were performed between patients with satisfactory and unsatisfactory outcome; and patients with successful and unsuccessful outcome. The overall success rate according to subjective and objective assessment was 60%. However, 9 of 10 patients with unsatisfactory and/or unsuccessful outcome (90%) had severe chronic inflammation of lacrimal sac. In subjective assessment, inflammatory cell infiltration (p = 0.050), fibrosis (p = 0.037), capillary proliferation (p = 0.007) and chronic inflammation (p = 0.003) had a statistically significant difference between patients with satisfactory and unsatisfactory outcome. In objective assessment, statistically significant differences were detected between patients with successful and unsuccessful outcome when they compared according to inflammatory cell infiltration (p = 0.027), capillary proliferation (p = 0.007) and chronic inflammation (p = 0.003). Chronic inflammation related histopathological features of variable degree may have a role on En-DCR outcome. Chronic inflammatory score can be used as an indicator of En-DCR success. © 2011 Springer-Verlag.