Skip to main content
SpringerLink
Log in

Debates in Dacryology: The Ostium Dilemma

  • Chapter
  • First Online:
Book cover Principles and Practice of Lacrimal Surgery

  • 1177 Accesses

Abstract

One of the commonest causes of dacryocystorhinostomy (DCR) failure is the closure of the ostium due to healing of the mucosal edges, formation of synechiae, or presence of granulation tissue [1]. Another postulated cause of failure is the sump syndrome where a remnant of the inferior lacrimal sac acts as a nondraining reservoir [2]. These complications can be minimized by creating an adequately sized and appropriately placed ostium.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 109.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 149.00
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

References

  1. Allen KM, Berlin AJ. Intranasal endoscopic analysis of dacryocystorhinostomy failure. Ophthal Plast Reconstr Surg. 1988;4:143–5.

    Article  PubMed  CAS  Google Scholar 

  2. Welham RA, Henderson PH. Results of dacryocystorhinostomy: analysis of causes for failure. Trans Ophthalmol Soc U K. 1973;93:601–9.

    PubMed  CAS  Google Scholar 

  3. Wormald P, Kew J, van Hasselt CA. The intranasal anatomy of the naso-lacrimal sac in endoscopic dacryocystorhinostomy. Otolaryngol Head Neck Surg. 2000;123:307–10.

    Article  PubMed  CAS  Google Scholar 

  4. Wormald P. Powered endoscopic dacryocystorhinostomy. Laryngoscope. 2002;112:69–72.

    Article  PubMed  Google Scholar 

  5. Rose GE. The lacrimal paradox: toward a greater understanding of success in lacrimal surgery. Ophthal Plast Reconstr Surg. 2004;20:262–5.

    Article  PubMed  Google Scholar 

  6. Argin A, Görür K, Ozcan C, et al. The role of larger osteotomy in long term success in external dacryocystorhinostomy. J Plast Reconstr Aesthet Surg. 2008;61:615–9.

    Article  PubMed  Google Scholar 

  7. Ben Simon GJ, Brown C, McNab AA. Larger osteotomies result in larger ostia in external dacryocystorhinostomies. Arch Facial Plast Surg. 2012;14:127–31.

    Article  PubMed  Google Scholar 

  8. Chan W, Selva D. Ostium shrinkage after endoscopic dacryocystorhinostomy. Ophthalmology. 2013;120:1693–6.

    Article  PubMed  Google Scholar 

  9. Ezra E, Restori M, Mannor GE, et al. Ultrasonic assessment of rhinostomy size following external dacryocystorhinostomy. Br J Ophthalmol. 1998;82:786–9.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  10. Bumsted RM, Linberg JV, Anderson RL, et al. External dacryocystorhinostomy: a prospective study comparing the size of the operative and healed ostium. Arch Otolaryngol. 1982;108:407–10.

    Article  PubMed  CAS  Google Scholar 

  11. Mann B, Wormald PJ. Endoscopic assessment of the dacryocystorhinostomy ostium after endoscopic surgery. Laryngoscope. 2006;116:1172–4.

    Article  PubMed  Google Scholar 

  12. Goldberg R. Endonasal dacryocystorhinostomy: is it really less successful? Arch Ophthalmol. 2004;122:108–10.

    Article  PubMed  Google Scholar 

  13. Konuk O, Kurtulmusoglu M, Knatova Z, et al. Unsuccessful lacrimal surgery: causative factors and results of surgical management in a tertiary referral center. Ophthalmologica. 2010;224:361–6.

    Article  PubMed  Google Scholar 

  14. Chastain J, Cooper MH, Sindwani R. The maxillary line: anatomic characterization and clinical utility of an important surgical landmark. Laryngoscope. 2005;115:990–2.

    Article  PubMed  Google Scholar 

  15. Orhan M, Saylam CY, Midilli R. Intranasal localization of the lacrimal sac. Arch Otolaryngol Head Neck Surg. 2009;135:764–70.

    Article  PubMed  Google Scholar 

  16. Ali MJ, Nayak JV, Vaezeafshar R, et al. Anatomic relationship of nasolacrimal duct and major lateral wall landmarks: cadaveric study with surgical implications. Int Forum Allergy Rhinol. 2014;4:684–8.

    Google Scholar 

  17. Shams P, Abed SF, Shen S, et al. A cadaveric study of the morphometric relationships and bony composition of the caucasian nasolacrimal fossa. Orbit. 2012;31:159–61.

    Article  PubMed  Google Scholar 

  18. Bisaria K, Saxena RC, Bisaria SD, et al. The lacrimal fossa in Indians. J Anat. 1989;166:265–8.

    PubMed  CAS  PubMed Central  Google Scholar 

  19. Woo K, Maeng HS, Kim YD. Characteristics of intranasal structures for endonasal dacryocystorhinostomy in Asians. Am J Ophthalmol. 2011;152:491–8.

    Article  PubMed  Google Scholar 

  20. McLean C, Cree IA, Rose GE. Rhinostomies: an open and shut case? Br J Ophthalmol. 1999;83:1300–1.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  21. Khalifa MA, Ragab SM, Saafan ME, et al. Endoscopic dacryocystorhinostomy with double posteriorly based nasal and lacrimal flaps: a prospective randomized controlled trial. Otolaryngol Head Neck Surg. 2012;147:782–7.

    Article  PubMed  Google Scholar 

  22. Kansu L, Aydin E, Avci S, et al. Comparison of surgical outcomes of endonasal dacryocystorhinostomy with or without mucosal flaps. Auris Nasus Larynx. 2009;36:555–9.

    Article  PubMed  Google Scholar 

  23. Massegur H, Trias E, Adema JM. Endoscopic dacryocystorhinostomy: modified technique. Otolaryngol Head Neck Surg. 2004;130:39–46.

    Article  PubMed  Google Scholar 

  24. Tsirbas A, Wormald PJ. Mechanical endonasal dacryocystorhinostomy with mucosal flaps. Br J Ophthalmol. 2003;87:43–7.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  25. Turkcu FM, Oner V, Tas M, et al. Anastomosis of both posterior and anterior flaps or only anterior flaps in external dacryocystorhinostomy. Orbit. 2012;31:383–5.

    Article  PubMed  Google Scholar 

  26. Serin D, Alagoz G, Karslioglu S, et al. External dacryocystorhinostomy: double-flap anastomosis or excision of the posterior flaps? Ophthal Plast Reconstr Surg. 2007;23:28–31.

    Article  PubMed  Google Scholar 

  27. Baldeschi L, MacAndie K, Hintschich C. The length of unsutured mucosal margins in external dacryocystorhinostomy. Am J Ophthalmol. 2004;138:840–4.

    Article  PubMed  Google Scholar 

  28. Kao SC, Liao CL, Tseng JH, et al. Dacryocystorhinostomy with intraoperative mitomycin C. Ophthalmology. 1997;10:486–91.

    Google Scholar 

  29. Mudhol R, Zingade ND, Mudhol RS, et al. A prospective randomized comparison of mitomycin C application in endoscopic and external dacryocystorhinostomy. Indian J Otolaryngol Head Neck Surg. 2013;65:255–9.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Tirakunwichcha S, Aeumjaturapat S, Sinprajakphon S, et al. Efficacy of mitomycin C in endonasal endoscopic dacryocystorhinostomy. Laryngoscope. 2011;121:433–6.

    Article  PubMed  CAS  Google Scholar 

  31. Feng YF, Yu JG, Shi JL, et al. A meta-analysis of primary external dacryocystorhinostomy with and without mitomycin C. Ophthalmic Epidemiol. 2012;19:364–70.

    Article  PubMed  Google Scholar 

  32. Cheng SM, Feng YF, Xu L, et al. Efficacy of mitomycin C in endoscopic dacryocystorhinostomy: a systematic review and meta-analysis. PLoS One. 2013;8:e62737.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  33. Zilelioglu G, Ugurbas SH, Anadolu Y, et al. Adjunctive use of mitomycin C on endoscopic lacrimal surgery. Br J Ophthalmol. 1998;82:63–6.

    Article  PubMed  CAS  Google Scholar 

  34. Prasanaraj T, Kumar P, Narasimhan I, et al. Significance of adjunctive mitomycin C in endoscopic dacryocystorhinostomy. Am J Otolaryngol. 2012;33:47–50.

    Article  Google Scholar 

  35. 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.

    Article  PubMed  Google Scholar 

  36. You Y, Fang CT. Intraoperative mitomycin C in dacryocystorhinostomy. Ophthal Plast Reconstr Surg. 2001;17:115–9.

    Article  PubMed  CAS  Google Scholar 

  37. Ari S, Gun R, Surmeli S, et al. Use of adjunctive mitomycin C in external dacryocystorhinostomy surgery compared with surgery alone in patients with nasolacrimal duct obstruction: a prospective, double masked, randomized controlled trial. Curr Ther Res Clin Exp. 2009;70:267–73.

    Article  PubMed  CAS  PubMed Central  Google Scholar 

  38. Ali MJ, Mariappan I, Maddileti S, et al. Mitomycin C in dacryocystorhinostomy: the search for the right concentration and duration – a fundamental study on human nasal mucosa fibroblast. Ophthal Plast Reconstr Surg. 2013;29:469–74.

    Article  PubMed  Google Scholar 

  39. Kamal S, Ali MJ, Naik MN. Circumostial injection of mitomycin C in external and endoscopic dacryocystorhinostomy: efficacy, safety profiles and outcomes. Ophthal Plast Reconstr Surg. 2014;30:187–90.

    Article  PubMed  Google Scholar 

  40. Bakri K, Jones N, Downes R, et al. Intraoperative Fluorouracil in endonasal Laser dacryocystorhinostomy. Arch Otolaryngol Head Neck Surg. 2003;129:233–5.

    Article  PubMed  Google Scholar 

  41. Costa MN, Marcondes AM, Sakano E, et al. Endoscopic study of the intranasal ostium in external dacryocystorhinostomy. Postoperative influence of saline solution and 5-Fluorouracil. Clinics. 2007;62:41–6.

    Article  PubMed  Google Scholar 

  42. Wu W, Cannon PS, Yan W, et al. Effects of Merogel coverage on wound healing and ostial patency in endonasal endoscopic dacryocystorhinostomy for primary chronic dacryocystitis. Eye (Lond). 2011;25:746–53.

    Article  CAS  Google Scholar 

  43. Marcet MM, Kuk AKT, Phelps PO. Evidence-based review of surgical practices in endoscopic endonasal dacryocystorhinostomy for primary acquired nasolacrimal duct obstruction and other new indications. Curr Opin Ophthalmol. 2014;25:443–8.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Ophthalmology, Wye Valley Trust, NHS, Hereford, UK

    Andrea Zarkovic FRANZCO & Simon N. Madge FRCOphth

  2. Ophthalmic Plastics Surgery, Royal Adelaide Hospital, Adelaide, SA, Australia

    Edwin C. Figueira FRANZCO

  3. Department of Ophthalmology, University of Hong Kong, Cyberport, Hong Kong

    Marcus M. Marcet MD

  4. Ophthalmology and Visual Sciences, University of Adelaide, Adelaide, SA, Australia

    Dinesh Selva FRANZCO

Authors
  1. Andrea Zarkovic FRANZCO
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Edwin C. Figueira FRANZCO
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Simon N. Madge FRCOphth
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Marcus M. Marcet MD
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Dinesh Selva FRANZCO
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Dinesh Selva FRANZCO .

Editor information

Editors and Affiliations

  1. Dacryology, L.V.Prasad Eye Institute, Hyderabad, India

    Mohammad Javed Ali

Rights and permissions

Reprints and permissions

Copyright information

© 2015 Springer India

About this chapter

Cite this chapter

Zarkovic, A., Figueira, E.C., Madge, S.N., Marcet, M.M., Selva, D. (2015). Debates in Dacryology: The Ostium Dilemma. In: Javed Ali, M. (eds) Principles and Practice of Lacrimal Surgery. Springer, New Delhi. https://doi.org/10.1007/978-81-322-2020-6_35

Download citation

  • DOI: https://doi.org/10.1007/978-81-322-2020-6_35

  • Published:

  • Publisher Name: Springer, New Delhi

  • Print ISBN: 978-81-322-2019-0

  • Online ISBN: 978-81-322-2020-6

  • eBook Packages: MedicineMedicine (R0)

Publish with us

Policies and ethics

Search

Navigation