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Salvage of impending rhinostomy failure after dacryocystorhinostomy with office-based microdebrider treatment

  • Oculoplastics and Orbit
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Abstract

Purpose

This article is to introduce office-based salvage revision of impending rhinostomy failure after endoscopic dacryocystorhinostomy (EN-DCR), using a microdebrider.

Methods

The authors conducted retrospective medical chart review of 27 eyes of 26 patients who underwent microdebrider treatment for impending rhinostomy failure in an office setting. After local anesthesia, obstructive soft tissue, interfering with ostium function (granuloma, cicatrization, synechia), was treated with a microdebrider (Osseoduo s120, Bien-Air Surgery, Le Noirmont, Switzerland) within 6 months after primary EN-DCR. Anatomical improvement and functional relief of epiphora were evaluated after revision.

Results

The causes of impending rhinostomy failure were granuloma formation (17/27 eyes, 63.0%), cicatrization (8/27 eyes, 29.6%), and synechial formation (2/27 eyes, 7.4%). The surgery did not exceed 5 min in all cases, and partial damage to pre-placed silicone tubes occurred in the first two cases (7.4%). Salvage revision resulted in anatomical success in all eyes, based on patent syringing and a positive functional endoscopic dye test. All cases showed improvement of epiphora after revision surgery.

Conclusions

Office-based salvage revision using a microdebrider provided effective management of impending rhinostomy failure during early follow-up period after primary EN-DCR. It enabled prompt management of excessive wound healing interfering with ostium function, while performing the routine postoperative nasal debridement.

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Authors and Affiliations

  1. Department of Ophthalmology, Dongguk University Gyeongju Hospital, 87 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do, 38067, South Korea

    Suhwan Kim & Jongyeop Park

  2. Department of Otorhinolaryngology, Dongguk University Gyeongju Hospital, 87 Dongdae-ro, Gyeongju-si, Gyeongsangbuk-do, 38067, South Korea

    Chang Hoi Kim

  3. Gyeongju Kim’s Eye Clinic, 288, Wonhwa-ro, Gyeongju-si, Gyeongsangbuk-do, 38147, South Korea

    Hochang Kim

Authors
  1. Suhwan Kim
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Contributions

Conception and design: J.P. and H.K; conduct the study: S.K., C.H.K, and J.P.; collection, management, and interpretation of data: S.K., C.H.K., J.P., and H.K.; data analysis: S.K. and C.H.K.; wrote the article: S.K. and J.P.; and preparation, review, and approval of the manuscript: J.P. and H.K.

S.K. and C.H.K contributed equally to the manuscript as the co-first author.

J.P and H.K contributed equally to the manuscript as the co-corresponding authors.

All authors reviewed the manuscript and approved the final version

Corresponding authors

Correspondence to Jongyeop Park or Hochang Kim.

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Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the Helsinki Declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Conflict of interest

The authors declare no competing interests.

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Suhwan Kim and Chang Hoi Kim contributed equally to this work as co-first authors.

Jongyeop Park and Hochang Kim contributed equally to this work as co-corresponding authors.

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Kim, S., Kim, C.H., Park, J. et al. Salvage of impending rhinostomy failure after dacryocystorhinostomy with office-based microdebrider treatment. Graefes Arch Clin Exp Ophthalmol 260, 1315–1321 (2022). https://doi.org/10.1007/s00417-021-05421-8

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  • DOI: https://doi.org/10.1007/s00417-021-05421-8

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