Surgical Outcomes of Canalicular Trephination Combined with Endoscopic Dacryocystorhinostomy in Patients with Distal or Common Canalicular Obstruction
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Purpose: This study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique. Methods: We retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient’s subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon. Results: Functional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test). Conclusions: The success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.
Abstract
Purpose: This study investigated the surgical outcomes of canalicular trephination combined with endoscopic dacryocystorhinostomy (DCR) in patients with a distal or common canalicular obstruction. It also identified the factors affecting surgical success rates associated with this technique. Methods: We retrospectively reviewed the medical records of 57 patients (59 eyes) in whom a canalicular obstruction was encountered during endoscopic DCR. All patients were treated with endoscopic DCR, followed by canalicular trephination and silicone tube placement. The surgical outcome was categorized as a functional success according to the patient’s subjective assessment of symptoms, including epiphora, and as an anatomical success according to a postoperative nasolacrimal duct irrigation test. Surgical success rates were compared based on age, sex, location of the obstruction, number of silicone tubes, and experience of the surgeon. Results: Functional success was achieved in 55 of 59 eyes (93%) at one month, 50 eyes (84%) at three months, and 46 eyes (78%) at six months. Anatomical success was achieved in 58 of 59 eyes (98%) at one month, 52 eyes (88%) at three months, and 50 eyes (84%) at six months. There was a statistically significant difference in surgical outcome according to the experience of the surgeon. The anatomical success rate at the six-month follow-up exam was 95.4% in the >5 years of experience group, and 53.3% in the <5 years of experience group (p = 0.008, Pearson chi-square test). Conclusions: The success rate of canalicular trephination combined with endoscopic DCR in patients with a distal or common canalicular obstruction decreased gradually during the six-month follow-up period. In particular, patients undergoing procedures with experienced surgeons tended to show excellent surgical outcomes at the six-month follow-up exam.
참고문헌 (15)
- Nemet AY, "Endoscopic dacryocystorhinostomy with adjunctive mitomycin C for canalicular obstruction", Orbit, 26, pp.97~100 (2007)
- Welham RA, "Results of dacryocystorhinostomy analysis of causes for failure", Trans Ophthalmol Soc U K, 93, pp.601~609 (1973)
- Boboridis K, "Nasolacrimal intubation with mitomycin C", Ophthalmology, 111, pp.416~417 (2004)
- 백병준, "Surgical Results of Endoscopic Dacryocystorhinostomy and Lacrimal Trephination in Distal or Common Canalicular Obstruction", Clinical and Experimental Otorhinolaryngology, 5(2), pp.101~106 (2012), 대한이비인후과학회[DOI]
- Boboridis KG, "Outcome of external dacryocystorhinostomy combined with membranectomy of a distal canalicular obstruction", Am J Ophthalmol, 139, pp.1051~1055 (2005)
- Narioka J, "Transcanalicular-endonasal semiconductor diode laser-assisted revision surgery for failed external dacryocystorhinostomy", Am J Ophthalmol, 146, pp.60~68 (2008)
- Hwang SW, "Bicanalicular double silicone intubation in external dacryocystorhinostomy and canaliculoplasty for distal canalicular obstruction", Acta Ophthalmologica, 87, pp.438~442 (2009)
- Khoubian JF, "Trephination and silicone stent intubation for the treatment of canalicular obstruction: effect of the level of obstruction", Ophthal Plast Reconstr Surg, 22, pp.248~252 (2006)
- Jones LT, "The cure of epiphora due to canalicular disorders, trauma and surgical failures on the lacrimal passages", Trans Am Acad Ophthalmol Otolaryngol, 66, pp.506~524 (1962)
- Jones LT, "Conjunctivodacryocystorhinostomy", Am J Ophthalmol, 59, pp.773~783 (1965)
- Nathoo NA, "Trephination for canalicular obstruction: experience in 45 eyes", Orbit, 32, pp.281~284 (2013)
- 유영근, "눈물소관 폐쇄에서 2개의 실리콘관을 이용한 내시경적 눈물소관코눈물주머니연결술의 임상성적", 대한안과학회지, 45(6), pp.2~2 (2004), 대한안과학회
- 김세종, "공통눈물소관 폐쇄에서 두 개의 실리콘관을 삽입한 코경유 눈물주머니코안연결술의 수술 결과", 대한안과학회지, 48(9), pp.1170~1176 (2007), 대한안과학회
- Paik JS, "Bicanalicular double silicone stenting in endoscopic dacryocystorhinostomy with lacrimal trephination in distal or common canalicular obstruction", Eur Arch Otorhinolaryngol, 269, pp.1605~1611 (2012)
- Chong KK, "Randomized trial on silicone intubation in endoscopic mechanical dacryocystorhinostomy (SEND) for primary nasolacrimal duct obstruction", Ophthalmology, 120, pp.2139~2145 (2013)