Kalaivani, M A (2022) Comparative study of Surgical Outcomes in Endoscopic Dacryocystorhinostomy With and Without Stent. Masters thesis, Chengalpattu Medical College, Chengalpattu.
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Abstract
INTRODUCTION: Epiphora is defined as the overflow of tears due to obstruction of lacrimal passage. Acquired nasolacrimal duct obstruction can be classified into primary and secondary. Primary nasolacrimal duct obstruction is caused by inflammation and fibrosis without any precipitating cause. Secondary nasolacrimal duct obstruction can be due to infections, inflammatory reactions, neoplastic, traumatic or mechanical obstruction. Primary nasolacrimal duct obstruction is more common in middle aged and elderly women. It has been demonstrated that women have significantly smaller dimensions in the lower nasolacrimal fossa and middle nasolacrimal duct. ❖ Dacryocystorhinostomy is an effective and safe method for the treatment of nasolacrimal duct obstruction2. It can be performed externally or endoscopically. Caldwell was the first to describe an endonasal approach to treat nasolacrimal duct obstruction (NLDO) in 18933. The popularity of intranasal dacryocystorhinostomy(DCR) was limited throughout the twentieth century due to poor visualization of the surgical site. With the advent of fibreoptic endoscopes and rigid endoscopic techniques in the late 1980s and early 1990s, there has been renewed interest over the past decade in endoscopic DCR. Endoscopic DCR has many advantages over external DCR. AIMS AND OBJECTIVES AIMS: To assess the surgical outcomes of endoscopic dacryocystorhinostomy with and without stent placement. OBJECTIVES: 1. To compare the results of performing endonasal dacryocystorhinostomy for primary nasolacrimal duct obstruction with and without stent placement. 2. To assess the patency of the lacrimal drainage system after endoscopic dacryocystorhinostomy. MATERIALS AND METHODS: Design of study: Randomized controlled trial (RCT). Duration of study: 12 months. Period of the study: April 2020 to March 2021. Study Centre: Department of Otorhinolaryngology, Chengalpattu Medical College& Hospital, Chengalpattu. Study Population: Chronic dacryocystitis cases admitted at Chengalpattu Medical College Hospital, Chengalpattu. Selection criteria:- Inclusion criteria: Patients above the age of 18 years diagnosed as chronic dacryocystitis due to primary nasolacrimal duct obstruction. Exclusion criteria: ● Patients less than 18 years of age. ● Cases of congenital dacryocystitis. ● Patients with suspected presaccal obstruction canalicular obstruction and punctal stenosis. ● Atrophic sac & failed external DCR. ● Coexisting nasal pathologies which could influence the outcome of the surgery like atrophic rhinitis, chronic granulomatous diseases of the nose, any nasal tumours. ● Post traumatic and post radiation epiphora. ● Immunocompromised patients, uncontrolled systemic diseases. Methodology: The study includes 60 individuals of either gender who have symptoms and signs suggestive of chronic dacryocystitis and fulfill the inclusion criteria. Informed consent is obtained. A thorough examination of the patient is performed, including a detailed history and a complete ocular examination that includes slit lamp biomicroscopy and sac syringing. To rule out any obvious nasal or paranasal causes for the duct obstruction, a thorough clinical examination of the nose and paranasal sinuses is performed. Routine blood (Hb percent, TC, DC, ESR) and urine examinations, X-ray PNS, CT PNS and diagnostic nasal endoscopy are done. CONCLUSION: A comparative study of En DCR with and without silicone stenting is done in 60 cases of chronic dacryocystitis where silicone was used as a stenting material in 50% of the randomly divided cases. This study was done at Chengalpattu Medical College Hospital, from April 2020 to March 2021. • The overall success rate in our study with silicone as stent is 97% (Group B) and that without stenting is 90% (Group A). • Complete symptomatic relief was reported by 93% of cases in group A and 90% in group B. • Based on our study and results, to conclude that stenting did not make much difference statistically in the surgical outcomes of the two groups.
| Item Type: | Thesis (Masters) |
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| Additional Information: | 221914552 |
| Uncontrolled Keywords: | Surgical Outcomes, Endoscopic Dacryocystorhinostomy, With and Without Stent, Comparative study. |
| Subjects: | MEDICAL > Otolaryngology > MEDICAL > Otolaryngology |
| Depositing User: | Subramani R |
| Date Deposited: | 22 Apr 2022 16:23 |
| Last Modified: | 17 Dec 2023 13:15 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/19384 |
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