Since then, endonasal endoscopic dcr ees dcr was performed more frequently in pando and successful results were reported. The necessity of silicone stenting in endoscopic dacryocystorhinostomy dcr procedures is a controversial subject in the literature. Comparison of endoscopic revision for failed primary external. Objective to assess the results of microsurgical endonasal dacryocystorhinostomy with longterm insertion of single or double bicanalicular silicone tubes in canalicular presaccal and ductal postsaccal stenosis of the nasolacrimal duct system. Researchers from hyderabad, india, applied the lacq on 50 patients who underwent a total of 55 powered endoscopic dcr and found that the postoperative scores corroborated with the success rates from an anatomic standpoint. Endoscopic dcr is safe and effective in children presenting with persistent epiphora. This narrated video demonstrates nasal preparation for endoscopic dacryocystorhinostomy dcr surgery. Endoscopic revision of external dacryocystorhinostomy. By fully preserving all the lacrimal mucosa during opening of. Powered endoscopic dcr allows the lacrimal sac to be fully exposed so that it stands proud of the lateral nasal wall after dissection. Outcome and complications of endoscopic dacryocystorhinostomy without stenting muhammad ayoob, 1 khalid mahida, 2 qurat ulain, 3 and zafar dawood 4 1 muhammad ayoob, fcps, assistant professor of ophthalmology, ziauddin university hospital, keamari, karachi, pakistan.
Endoscopic versus external approach dacryocystorhinostomy. Edcr is a safe and effective alternative to traditional external dcr surgery, and offers comparable success rates. When watering of the eyes doesnt respond to conservative measures, dcr is indicated. Comparison of endoscopic revision for failed primary. The importance of using a mucosal flap technique remains unclear because success rates appear to be excellent with a variety of approaches. The diagnosis is clinical, so a thorough clinical history and. The diagnosis is clinical, so a thorough clinical history and physical. In that article, they describe the identification of the frontal. Endoscopic dacryocystorhinostomy to treat congenital nasolacrimal. These attempts were abandoned because of technical limitations in terms of poor visualization of.
Dacryocystorhinostomy or dcr is one of the most common oculoplastics surgery performed. These improvements are the result of evolution in surgical instruments, improvement in endoscopic equipment and growing surgical experience. Apr 22, 2019 endoscopic dacryocystorhinostomy dcr is a recognized procedure performed to treat epiphora caused by anatomical or functional obstruction of the nasolacrimal apparatus. With the recent proliferation of endoscopic surgical techniques, there has been renewed interest in performing dacryocystorhinostomy dcr via an intranasal endoscopic approach. Tearing and recurrent or chronic conjunctival discharge are the mostfrequent symptoms and signs of a lacrimal pathway obstruction. It is a simple, less time consuming, safe but skilful, highly satisfying surgery both for. Dacryocystorhinostomy dcr is the standard treatment for nasolacrimal duct obstruction1. A comparative study between powered and nonpowered technique. Both kerrison punch and drill are widely used in endoscopic dcr with nonconclusive knowledge about differences. Endoscopic dacryocystorhinostomy with double posteriorly. A retrospective study in a single, academic institution.
Both kerrison punch and drill are widely used in endoscopic dcr with nonconclusive knowledge about. Endoscopic dacryocystorhinostomy bjorl brazilian journal of. Article information, pdf download for comparative external versus. Endoscopic dacryocystorhinostomy dcr was first described by. Endoscopic dacryocystorhinostomy is a minimally invasive endoscopic technique that offers good longterm surgical outcome. The key to success includes exposure of the whole sac including the fundus, creation of wide nasolacrimal window, mucosal preservation and meticulous postoperative care. Pediatric endonasal endoscopic dacryocystorhinostomy is a safe and effective procedure to correct nasolacrimal system obstruction in cases that are unresponsive to conservative treatments. However, up to date, the efficacy and safety of ned for the treatment of cd is still inconclusive. Endoscopic transnasal dacryocystorhinostomy volume 103 issue 6 m.
There is limited evidence in literature determining age effect on outcomes of endoscopic dacryocystorhinostomy edcr in adult patients with primary acquired nasolacrimal duct. Endoscopic dacryocystorhinostomy edcr using telescopes has gained a lot of momentum among otolaryngologists, since the outcomes are comparable to the external approach. In this procedure, a nasal endoscope is used to visualise the lacrimal sac through the nasal cavity. The national institute for health and clinical excellence nice has issued full guidance to the nhs in england, wales, scotland and northern ireland on endoscopic dacryocystorhinostomy. Efficacy of nasal endoscopic dacryocystorhinostomy for. Pdf endoscopic dacryocystorhinostomy as treatment for lower. Endoscopic dacryocystorhinostomy sprekelsen 1996 the. Article information, pdf download for endoscopic dacryocystorhinostomy. Significant refinements in technique and instrumentation coupled with an improved understanding of the endoscopic surgical anatomy are largely. Objectivesto conduct the first prospective randomized controlled trial assessing and comparing the safety and efficacy of endoscopic dacryocystorhinostomy dcr with. Nasal endoscopic dacryocystorhinostomy ned are reported to treat cd by numerous clinical trials.
Dec 27, 2019 there is limited evidence in literature determining age effect on outcomes of endoscopic dacryocystorhinostomy edcr in adult patients with primary acquired nasolacrimal duct obstruction nldo. Experience at sheikh zayed hospital, lahore canthal structures, cerebrospinal fluid rhinorrhea and functional interference with the physiological action of the lacrimal pump are major drawbacks8. Endoscopic endonasal dacryocystorhinostomy is an effective treatment for nasolacrimal duct obstruction. It may be performed through an external skin incision or intranasally with or without endoscopic visualization. Nov 30, 2011 eedcr is a highly rewarding endoscopic procedure for management of dacryocystitis when epiphora does not respond to medications or repeated syringing of nasolacrimal duct. Nasolacrimal duct dysfunction has many different etiologies. Pediatric endonasal endoscopic dacryocystorhinostomy. A dacryocystorhinostomy dcr is a type of surgery done to create a new tear drain between your eyes and nose. Endoscopic dacryocystorhinostomy videos oculoplastic.
Although the endonasal approach was for the first time introduced by caldwell in 1893, its use stayed. Pdf endonasal endoscopic dacryocystorhinostomy for. Powered endoscopic dacryocystorhinostomy with mucosal. Eedcr is a highly rewarding endoscopic procedure for management of dacryocystitis when epiphora does not respond to medications or repeated syringing of nasolacrimal duct. Endoscopic dacryocystorhinostomy pubmed central pmc.
Endoscopicpowered dacryocystorhinostomy without stenting. Endoscopic dacryocystorhinostomy dcr is used to treat epiphora caused by anatomic or functional obstruction of the nasolacrimal apparatus. Endoscopic ultrasonic dacryocystorhinostomy for recurrent. An uncinectomy, septoplasty, and anterior middle turbinectomy contribute to the optimal clearance of the common canaliculus and ultimate surgical success. In group 2, endoscopic primary endonasal dcr with hammerchisel removal of bone. A intraoperative navigation ct image guidance showing relevant anatomy of the paranasal sinuses and lacrimal drainage system in the coronal plane. You may need this surgery if your own tear duct has become blocked.
Objective the purpose of the present study is to assess the longterm anatomical and functional outcomes of endoscopic powered dcr epdcr without stenting or mucosal flaps. Endoscopic dacryocystorhinostomy dcr is a widely performed and safe procedure for the treatment of nasolacrimal duct obstruction manifested as. View enhanced pdf access article on wiley online library html view download pdf for offline viewing. Pdf to study the outcome of endonasal endoscopic dacryocystorhinostomy dcr with or without mucosal flap preservation, without. The correction of the structural anatomic alterations might facilitate surgical treatment. Endoscopic dacryocystorhinostomy, epiphora, lacrimal stents introduction caldwell1 was the first to describe an endonasal approach to treat nasolacrimal duct obstruction nldo. Unlimited viewing of the articlechapter pdf and any associated supplements and figures. Your eyelids have two small openings that drain some of the tears covering your eye. Endonasal endoscopic dacryocystorhinostomy in children. Pdf obstruction of the lacrimal pathway is manifested by epiphora, infection. Endoscopic dacryocystorhinostomy edcr using telescopes has gained a lot of. Endoscopic dacryocystorhinostomy dcr is a recognized procedure performed to treat epiphora caused by anatomical or functional obstruction of the nasolacrimal apparatus.
It explores the use of different decongesting and vasoconstricting preparations and the technique of placing them in the nasal cavity we also discusses the safe doses of the different preparations. Objectivesto conduct the first prospective randomized controlled trial assessing and comparing the safety and efficacy of endoscopic dacryocystorhinostomy dcr with double posteriorly based nasal. Dec 22, 2015 dacrocystorhinostomy dcr is an operation used to treat nasolacrimal duct obstruction. A modified preserved nasal and lacrimal flap technique in. Endoscopic transnasal dacryocystorhinostomy the journal. This surgery creates a new opening for tears to drain away from the eye. Intraoperative navigation computed tomography ct and endoscopic images of followup transnasal endoscopic dacryocystorhinostomy edcr performed on the patient described in figure 1. Endoscopic dacryocystorhinostomy oculoplastic eyelid orbit. Microsurgical endonasal dacryocystorhinostomy with long.
Dacryocystorhinostomy dcr consists of creating a lacrimal drainage pathway to the nasal cavity to restore permanent drainage of previously obstructed excreting system. Outcomes regarding the endoscopic dacryocystorhinostomy are, at leas, equal to those from the traditional external approach. Mar 26, 2018 dacryocystorhinostomy dcr is one possible tretment for blocked tear ducts. Multiple recent published studies have confirmed the value of the endoscopic dacryocystorhinostomy technique in the treatment of lacrimal obstruction. Endoscopic dacryocystorhinostomy dcr is a widely performed and safe procedure for the treatment of nasolacrimal duct obstruction manifested as epiphora or dacryocystitis. Unlimited viewing of the article pdf and any associated supplements and figures. Overview endoscopic dacryocystorhinostomy guidance nice. All patients were subjected to endonasal dacryocystorhinostomy dcr by endoscopic surgical technique using conventional instruments. Endoscopic dacryocystorhinostomy edcr is a currently wellestablished surgical treatment for patients with. Endoscopic endonasal dacryocystorhinostomy dcr is the best, scar free no scar, lacrimal surgery performed for restoration of tears flow into the nose from the lacrimal sac, when the nasolacrimal duct tear duct has become blocked blocked tear duct tear duct obstruction. Abnormal tearing or epiphora watery eyes takes place due to obstruction in.
Pdf endoscopic dacryocystorhinostomy jelena sotirovic. It is a bypass procedure that creates an anastomosis between the lacrimal sac and the nasal mucosa via a bony ostium. Objective the purpose of the present study is to assess the longterm anatomical and functional outcomes of endoscopicpowered. The medial wall of the sac is incised or excised, facilitating drainage of tears into the nasal cavity. View the article pdf and any associated supplements and figures for a period of 48 hours. Powered endoscopic dacryocystorhinostomy springerlink. Dacryocystorhinostomy dcr is a procedure performed for the treatment of tearing epiphora due to blockage of the nasolacrimal drainage system. Endoscopic dacryocystorhinostomy as treatment for lower. The results of 152 procedures were good or very good in 96% of cases, and no major complications occurred. Dacrocystorhinostomy dcr is an operation used to treat nasolacrimal duct obstruction. This study aims to evaluate the outcome of endoscopic dacryocystorhinostomy dcr and compare with the outcome of external dcr, based on data. Comparison of endoscopic revision for failed primary external versus endoscopic dacryocystorhinostomy. Objectives to describe powered endoscopic dacryocystorhinostomy.
Endoscopic dacryocystorhinostomy is a safe, fast and effective method to relieve a stenosis distal to the common canaliculus. Endoscopic dacryocystorhinostomy represents a new and promising approach to obstruction of lacrimal pathways. A success rate of 84% was achieved for cases of previous external dacryocystorhinostomy and 80. What is endoscopic dacryocystorhinostomy dcr surgery for. Dacryocystorhinostomy dcr this leaflet explains about dacryocystorhinostomy dcr including the benefits, risks and any alternatives, together with what you can expect when you come to hospital. Comparative external versus endoscopic dacryocystorhinostomy. Outcomes regarding the endoscopic dacryocystorhinostomy are, at leas, equal to those from the traditional external. Endoscopic dacryocystorhinostomy dcr is used to treat patients diagnosed with lacrimal sac or nasolacrimal duct obstruction nldo. With the advent of nasal endoscopes, endoscopic dacryocystorhinostomy is becoming popular. Endoscopic dacryocystorhinostomy oculoplastic eyelid. Heres why the recent shift from an external to endoscopic approach.
The present results demonstrate that endoscopic dacryocystorhinostomy represents a safe and effective alternative to the external approach in revisional cases. If you have any further questions, please speak to a doctor or nurse caring for you. Local anaesthetic endonasal endoscopic laser dacryocystorhinostomy. Edcr is a safe and effective alternative to traditional external dcr. The introduction of nasal endoscopy and endoscopic sinus surgery in the 1980s paved the way for a transnasal endoscopic approach to lacrimal system. Thus, endoscopic dacryocystorhinostomy provides satisfactory. This study aims to evaluate the outcome of endoscopic dacryocystorhinostomy dcr and compare with. Endoscopic transnasal dacryocystorhinostomy the journal of. It is a simple, less time consuming, safe but skilful, highly satisfying surgery both for the patients as well as the surgeons.
Endoscopic dacryocystorhinostomy edcr is the preferred approach for nasolacrimal duct obstruction, yet quality data on long. Objective to describe the indications, technique, and results of endonasal endoscopic dacryocystorhinostomy in children with congenital and acquired disorders of the nasolacrimal system. Revision endoscopic dacryocystorhinostomy sciencedirect. It explores the use of different decongesting and vasoconstricting preparations and the technique of placing them in the nasal cavity we. Mar 23, 2017 endoscopic dcr dacryocystorhinostomy 1. However, success is dependent on a thorough understanding of the endonasal anatomy, wide marsupialization of the lacrimal sac, and meticulous care of the mucosa. Dacryocystorhinostomy dcr is a surgical technique that has.
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