Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2018
Comparing Outcomes of the Standard Technique of Endoscopic DCR with Its Modifications: A Retrospective Analysis.
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Kumar Subodh, Mishra Awadhesh Kumar, Sethi Ashwani, Mallick Ajay, Maggon Nidhi, Sharma Harikesh, Gupta Anandita
Аннотация
OBJECTIVE: To compare the outcomes of various techniques of endoscopic dacryocystorhinostomy (DCR).
STUDY DESIGN: Retrospective case record analysis.
SETTINGS: Tertiary care referral center.
SUBJECT AND METHODS: Retrospective analysis of case records was carried out pertaining to the period from January 1996 to September 2017 with respect to patients who had undergone endoscopic DCR with either the standard technique or one of its modifications. Case notes showing well-documented preoperative evaluation, operative details, postoperative assessment, and minimum 6-month follow-up were considered. The outcomes were measured on the basis of patients' postoperative symptoms, clinical examination, and sac-syringing results.
RESULTS: A total of 423 patients were included in the study. Of these, 169 underwent standard endoscopic DCR; 87, endoscopic DCR with stent; 19, endoscopic DCR with mitomycin C; 62, powered DCR; 29, laser-assisted DCR; and 57, balloon DCR. There was no statistically significant difference in success rates, recurrences, or complications of various techniques at 3 or 6 months. Mean operating time was lowest for balloon DCR (mean ± SD, 27.1 ± 3.1 minutes), followed by standard endoscopic DCR (38.2 ± 3.6 minutes; P = .001).
CONCLUSION: Standard endoscopic DCR and its more sophisticated modifications were equally effective and safe in managing distal nasolacrimal drainage obstruction. Balloon DCR, followed by standard endoscopic DCR, was significantly faster than other techniques.
STUDY DESIGN: Retrospective case record analysis.
SETTINGS: Tertiary care referral center.
SUBJECT AND METHODS: Retrospective analysis of case records was carried out pertaining to the period from January 1996 to September 2017 with respect to patients who had undergone endoscopic DCR with either the standard technique or one of its modifications. Case notes showing well-documented preoperative evaluation, operative details, postoperative assessment, and minimum 6-month follow-up were considered. The outcomes were measured on the basis of patients' postoperative symptoms, clinical examination, and sac-syringing results.
RESULTS: A total of 423 patients were included in the study. Of these, 169 underwent standard endoscopic DCR; 87, endoscopic DCR with stent; 19, endoscopic DCR with mitomycin C; 62, powered DCR; 29, laser-assisted DCR; and 57, balloon DCR. There was no statistically significant difference in success rates, recurrences, or complications of various techniques at 3 or 6 months. Mean operating time was lowest for balloon DCR (mean ± SD, 27.1 ± 3.1 minutes), followed by standard endoscopic DCR (38.2 ± 3.6 minutes; P = .001).
CONCLUSION: Standard endoscopic DCR and its more sophisticated modifications were equally effective and safe in managing distal nasolacrimal drainage obstruction. Balloon DCR, followed by standard endoscopic DCR, was significantly faster than other techniques.
Предметные рубрики MeSH
AdultAgedAnalysis of VarianceChronic DiseaseCohort StudiesDacryocystitisDacryocystorhinostomyDrainageEndoscopyFemaleFollow-Up StudiesHumansLacrimal Duct ObstructionMaleMiddle AgedMinimally Invasive Surgical ProceduresPostoperative ComplicationsRetrospective StudiesRisk AssessmentStentsTertiary Care CentersTime FactorsTreatment Outcome