Reestablishing Lacrimal Drainage by Canaliculorhinostomy after Dacryocystectomy: A Viable Option in Symptomatic Patients
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Purpose: To evaluate the outcome and efficacy of a modified technique of canaliculo-dacryocystorhinostomy (canaliculo-DCR)in the complete absence of lacrimal sac, as a means to reestablish lacrimal drainage in postdacryocystectomy (post-DCT)patients. Methods: A retrospective, nonrandomized interventional study including 15 proven and established post-DCT patients withintact canaliculi of at least 7 to 8 mm. The patients presented with bothersome tearing to the oculoplastic clinic from January2017 to January 2018. Patients were operated by a single surgeon (ST). Procedure involved creating a bony ostium of optimumsize, internal membranectomy and the nasal mucosal flap anchored appropriately to create a passage in line with thecommon canaliculus. Adjunctively bicanalicular intubation and mitomycin-C were used. Results: Of the 15 patients who were operated (10 female and five male patients), 14 (93.33%) had functionally and anatomicallypatent lacrimal passage after the modified canaliculo-DCR, one (6.66%) was symptomatically better with partial regurgitationof clear fluid. Three (20%) had tube prolapse after 1st month postoperatively, which although significant, was notrelated to the technique. They were repositioned as an office procedure and retained thereafter till removal, no other tuberelated or mitomycin-C related sequelae was seen. No intraoperative complication was encountered. Conclusions: With a success rate of 93.33% and a resultant patent lacrimal tear drainage passage and trivial complicationsuch as tube prolapse, we can conclude, this technique of modified canaliculo-DCR in post-DCT patients is a safe and effectiveprocedure with promising results, thereby avoiding cumbersome methods and maintenance of Jones tube while at the sametime providing symptomatic relief to the patients.
Abstract
Purpose: To evaluate the outcome and efficacy of a modified technique of canaliculo-dacryocystorhinostomy (canaliculo-DCR)in the complete absence of lacrimal sac, as a means to reestablish lacrimal drainage in postdacryocystectomy (post-DCT)patients. Methods: A retrospective, nonrandomized interventional study including 15 proven and established post-DCT patients withintact canaliculi of at least 7 to 8 mm. The patients presented with bothersome tearing to the oculoplastic clinic from January2017 to January 2018. Patients were operated by a single surgeon (ST). Procedure involved creating a bony ostium of optimumsize, internal membranectomy and the nasal mucosal flap anchored appropriately to create a passage in line with thecommon canaliculus. Adjunctively bicanalicular intubation and mitomycin-C were used. Results: Of the 15 patients who were operated (10 female and five male patients), 14 (93.33%) had functionally and anatomicallypatent lacrimal passage after the modified canaliculo-DCR, one (6.66%) was symptomatically better with partial regurgitationof clear fluid. Three (20%) had tube prolapse after 1st month postoperatively, which although significant, was notrelated to the technique. They were repositioned as an office procedure and retained thereafter till removal, no other tuberelated or mitomycin-C related sequelae was seen. No intraoperative complication was encountered. Conclusions: With a success rate of 93.33% and a resultant patent lacrimal tear drainage passage and trivial complicationsuch as tube prolapse, we can conclude, this technique of modified canaliculo-DCR in post-DCT patients is a safe and effectiveprocedure with promising results, thereby avoiding cumbersome methods and maintenance of Jones tube while at the sametime providing symptomatic relief to the patients.
참고문헌 (17)
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