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Outcomes of endonasal endoscopic dacryocystorhinostomy after maxillectomy in patients with paranasal sinus and skull base tumors

  • Rhinology
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Abstract

Maxillectomy followed by radiotherapy and/or chemotherapy can result in lacrimal blockage and the need for subsequent dacryocystorhinostomy (DCR). Endonasal endoscopic DCR, as opposed to external DCR, allows better accuracy and leaves no scar. To date no report was published regarding the results of endoscopic DCR in these patients. The current study presents a retrospective review of all patients with paranasal and skull base tumors who developed nasolacrimal duct blockage after ablative maxillectomy with or without radiotherapy and/or chemotherapy and underwent endonasal endoscopic DCR between January 2006 and October 2012 in a tertiary reference medical center. According to our results, ten patients underwent 11 subsequent endonasal endoscopic DCR. There were 6 men and 4 women with a median age of 55 years (range, 19–81 years); four suffered from benign tumors and six had malignant tumors. All underwent maxillectomy. Six received high-dose radiotherapy. Time interval between primary ablative surgery and endonasal endoscopic DCR was 18 months (range, 7–118 months). Silicone stents were removed after median period of 11 weeks (range, 1–57 weeks). Nine out of ten patients experienced symptomatic improvement following one endonasal endoscopic DCR. One patient had recurrent epiphora and underwent a successful endonasal endoscopic revision DCR. In conclusion, endonasal endoscopic DCR in patients with paranasal and skull base tumors, who previously underwent maxillectomy, is generally successful and not associated with a high rate of complications or failure. Moreover, our findings may suggest that silicone stents can be removed shortly after the operation with high success rate.

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Acknowledgments

Dr. Orit Gutfeld, for helping with collecting data regarding the radiation therapy. Esther Eshkol, the institutional medical and scientific copyeditor, for editorial assistance.

Conflict of interest

None reported.

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Authors and Affiliations

  1. Department of Otolaryngology Head and Neck Surgery and Maxillofacial Surgery, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, 6 Weizman Street, 64239, Tel Aviv, Israel

    Sara Abu-Ghanem, Gilad Horowitz, Gadi Fishman, Dan M. Fliss & Avraham Abergel

  2. Department of Ophthalmology, Oculoplastic and Orbital Institute, Tel-Aviv Sourasky Medical Center, Sackler School of Medicine, Tel Aviv University, Tel-Aviv, Israel

    Ran Ben-Cnaan & Igal Leibovitch

Authors
  1. Sara Abu-Ghanem
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  2. Ran Ben-Cnaan
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  3. Igal Leibovitch
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  4. Gilad Horowitz
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  5. Gadi Fishman
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  6. Dan M. Fliss
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  7. Avraham Abergel
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Corresponding author

Correspondence to Avraham Abergel.

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Abu-Ghanem, S., Ben-Cnaan, R., Leibovitch, I. et al. Outcomes of endonasal endoscopic dacryocystorhinostomy after maxillectomy in patients with paranasal sinus and skull base tumors. Eur Arch Otorhinolaryngol 271, 1513–1518 (2014). https://doi.org/10.1007/s00405-013-2706-7

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  • DOI: https://doi.org/10.1007/s00405-013-2706-7

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