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Results and clinical aspects of primary endonasal endoscopic dacryocystorhinostomy with silicone tube

  • Rhinology
  • Published:
European Archives of Oto-Rhino-Laryngology Aims and scope Submit manuscript

Abstract

Objective

Endonasal endoscopic dacryocystorhinostomy (DCR) is a common treatment for saccal and post-saccal stenosis of the lacrimal pathway or chronic dacryocystitis (DC). The main symptom is chronic epiphora (tearing) and dacryocystitis (infection). The objective of this study is to assess the short-term surgical result of this treatment based on possible prognostic factors; such as gender, age, the pathogen spectrum and the histopathological result as well as the influence of these parameters on hospital stay.

Methods

It is a retrospective analysis, which includes 197 cases in 177 patients, who received an endonasal endoscopic DCR with a silicone tube between January 2009 and December 2016, as primary procedure. The follow-up was carried out 3 months after the surgery, with the silicone tube being removed as part of the last examination including a flushing of the tear ducts with saline. This procedure is part of determining to measure the short-term success of the intervention. The definition of success of the surgery is an absence of epiphora or an acute infection of the nasolacrimal duct system, as well as an absent reflux in case of flushing the tear duct.

Results

The success rate was 86.3% (N = 170). Higher incidence was seen in females (N = 146; 74.1%) and patients with a mean age of 65.4 (± 17.2). The presence of pathogens as well as the histopathological result do not have an impact on the short-term surgical success. Patients diagnosed with rheumatic diseases appear to have a worse prognosis with relation to procedure success. Also, the length of hospital stay was related to possible prognostic factors. Type II diabetes and glaucoma had a significant influence on a longer hospital stay.

Conclusion

The endonasal endoscopic DCR is a surgical procedure with high success rate. Patients with rheumatic diseases should be aware of increased failure rates. Patients with glaucoma and Type II diabetes might need a more intense aftercare.

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Data availability

Data are available on reasonable request to all interested researchers.

Abbreviations

DCR:

Dacryocystorhinostomy

DC:

Dacryocystitis

DM:

Type II diabetes mellitus

EN-DCR:

Endonasal endoscopic dacryocystorhinostomy

IL:

Interleucin

MNT:

Middle nasal turbinate

PANDO:

Primary acquired nasolacrimal duct obstruction

SALDO:

Secondary acquired nasolacrimal drainage obstruction

S. aureus:

Staphylococcus aureus

TNF:

Tumor necrosis factor

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Acknowledgements

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Funding

This research received no specific grant from any funding agency in the public, commercial or not-for-profit sectors.

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Authors and Affiliations

  1. Department of ENT, Head- and Neck-Surgery, Medical Center of Chemnitz, Flemmingstraße 2, 09116, Chemnitz, Germany

    Victoria Miragall, Jens Oeken & Christian Güldner

Authors
  1. Victoria Miragall
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  2. Jens Oeken
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  3. Christian Güldner
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The authors contributed to the design and implementation of the research, to the analysis of the results and to the writing of the manuscript.

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Correspondence to Victoria Miragall.

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Miragall, V., Oeken, J. & Güldner, C. Results and clinical aspects of primary endonasal endoscopic dacryocystorhinostomy with silicone tube. Eur Arch Otorhinolaryngol 279, 2409–2415 (2022). https://doi.org/10.1007/s00405-021-07004-z

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  • DOI: https://doi.org/10.1007/s00405-021-07004-z

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