Abstract
The two most common causes of dacryocystorhinostomy (DCR) failure are a common canalicular obstruction and unappropriate size and location of the osteotomy. Revision DCR is similar with a standard primary surgical method, such as an external or endoscopic DCR. However, to improve the success rate of repeated DCR, physicians should consider several important points. It is important to correct any nasal pathology that might have affected reported success rates, and to recreate an appropriate rhinostomy by removing the membranous or fibrotic tissue causing the present obstructions. The topical application of mitomycin C (MMC) or a betamethasone injection can be considered an adjunctive treatment for revision cases. Recently, laser-assisted canalicular DCR surgery has shown improved success rates, even in revision cases. Conjunctivodacryocystorhinostomy (CDCR) might be indicated in specific revision cases, including those involving proximal canalicular obstruction and intractable functional obstruction.
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References
Gupta VP, Gupta P, Gupta R. Causative factors of unsuccessful dacryocystorhinostomy and the surgical technique of revision external dacryocystorhinostomy. Ophthalmologica. 2011;225:236.
Konuk O, Kurtulmusglu M, Knatova Z, et al. Unsucessful lacrimal surgery: causative factors and results of surgical management in a tertiary center. Ophthalmologica. 2010;224:361–6.
Paik JS, Cho WK, Yang SW. Comparison of endoscopic revision for failed primary external versus endoscopic dacryocystorhinostomy. Clin Experiment Ophthalmol. 2013;41:116–21.
Choussy O, Retout A, Marie JP, et al. Endoscopic revision of external dacryocystorhinostomy failure. Rhinology. 2010;48:104–7.
Ari S, Kürşat Cingü A, Sahin A, et al. Outcomes of revision external dacryocystorhinostomy and nasal intubation by bicanalicular silicone tubing under endonasal endoscopic guidance. Int J Ophthalmol. 2012;5:238–41.
Mclean CJ, Cree IA, Rose GE. Rhinostomies: an open and shut case? Br J Ophthalmol. 1999;83:1300–1.
Mann BS, Wormald PJ. Endoscopic assessment of the dacryocystorhinostomy ostium after endoscopic surgery. Laryngoscope. 2006;116:1172–4.
El-Guindy A, Dorgham A, Ghoraba M. Endoscopic revision surgery for recurrent epiphora occurring after external dacyocystorhinostomy. Ann Otol Rhinol Laryngol. 2000;109:425–30.
Tsirbas A, Davis G, Wormald PJ. Revision dacryocystorhinostomy: a comparison of endoscopic and external techniques. Am J Rhinol. 2005;19(3):322–5.
Demarco R, Strose A, Araújo M, et al. Endoscopic revision of external dacryocystorhinostomy. Otolaryngol Head Neck Surg. 2007;137:297–9.
Korkut AY, Teker AM, Ozsutcu M, et al. A comparison of endonasal with external nacryocystorhinostomy in revision cases. Eur Arch Otorhinolaryngol. 2011;268:378–81.
Woog JJ, Kennedy RH, Custer PL, et al. Endonasal dacryocystorhinostomy: a report by the American Academy of Ophthalmology. Ophthalmology. 2001;108:2369–77.
Preechawai P. Results of nonendoscopic dacryocystorhinostomy. Clin Ophthalmol. 2012;6:1297–301.
Chan W, Selva D. Ostium shrinkage after endoscopic dacryocystorhinostomy. Ophthalmology. 2013;120:1693–6.
Cheng SM, Feng YF, Xu L, et al. Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systemic review and meta- analysis. PLoS One. 2013;8:e62737.
Ragab SM, Elsherif HS, Shehata EM, et al. Mitomycin C-enhanced revision endoscopic dacryocystorhinostomy: a prospective randomized controlled trial. Otolaryngol Head Neck Surg. 2012;147:937–42.
Penttilä E, Smirnov G, Seppä J, et al. Mitomycin C in revision endoscopic dacryocystorhinostomy: a prospective randomized study. Am J Rhinol Allergy. 2011;25:425–8.
Zeldovich A, Ghabrial R. Revision endoscopic dacryocystorhinostomy with betamethasone injection under assisted local anaesthetic. Orbit. 2009;28:328–31.
Patel BC, Phillips B, McLeish WM, et al. Tanscanalicular laser-assisted revision of failed dacryocystorhinostomy. Ophthalmology. 1997;104:1191–7.
Woo KI, Moon SH, Kim YD. Transcanalicular laser-assisted revision of failed dacryocystorhinostomy. Ophthalmic Surg Lasers. 1998;29:451–5.
Narioka J, Ohashi Y. Transcanalicular-endonasal semiconductor diode laser-assisted revision surgery for failed external dacryocystorhinostomy. Am J Ophthalmol. 2008;146:60–8.
Woog JJ, Sindawani R. Endoscopic dacryocystorhinostomy and conjunctivo-dacryocystorhinostomy. Otolaryngol Clin North Am. 2006;39:1001–17.
Athanasiov PA, Madge S, Kakizaki H, et al. A review of bypass tube for proximal lacrimal drainage obstruction. Surv Ophthalmol. 2011;56:252–66.
Crockett C, Lee S, Yen MT. Catheter-assisted conjunctivodacryocystorhinostomy (CDCR). Int Ophthalmol Clin. 2013;53:87–91.
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Yang, SW., Paik, JS. (2015). Revision Dacryocystorhinostomy. In: Cohen, A., Mercandetti, M., Brazzo, B. (eds) The Lacrimal System. Springer, Cham. https://doi.org/10.1007/978-3-319-10332-7_18
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DOI: https://doi.org/10.1007/978-3-319-10332-7_18
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