ISSN: 2148-4902 | E-ISSN: 2536-4553
Northern Clinics of Istanbul Comparison of Success Between External and Endonasal Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction in Turkish Cohort [North Clin Istanb]
North Clin Istanb. Ahead of Print: NCI-06888 | DOI: 10.14744/nci.2020.06888

Comparison of Success Between External and Endonasal Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction in Turkish Cohort

Bugra Karasu1, Gulunay Kiray2, Erdem Eris1, Irfan Perente1, Ali Riza Cenk Celebi3
1University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
2Umraniye Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey.
3Acibadem University School of Medicine Department of Ophthalmology, Istanbul, Turkey

Purpose: To evaluate the results and recurrence rates of external and endonasal dacryocystorhinostomy (DCR) surgery in patients with primary acquired nasolacrimal duct obstruction (PANDO) in Turkish Cohort
Material and Methods: Medical records were reviewed in all patients who underwent surgery for PANDO between January 2010 to September 2014 in a tertiary university hospital retrospectively. The patients were followed up on the first day, 1st month, 3rd month and 6th month postoperatively. Lacrimal drainage system and recurrence rates were recorded.
Results: The study was carried out in 81 patients, 27 of whom were men (33.3%) and 54 were women (66.7%). Mean follow up time was 30.13±16.42 months (range 6- 62 months). The mean age was 50.51 ± 12.47 years(range 16 to 77 years). External DCR was used in 44 (66.7%) of the cases and endonasal DCR was used in 37 (45.7%) of the cases. Surgical results of DCR were divided into 3 groups based on the integrity and openness of lacrimal drainage pathway in all PANDO patients. Operation success rates of these data revealed that 45(55.6%) cases were recorded as successful, 20 (24.7%) of the cases were accepted as partially successful and 16 (19.8%) of the cases were deemed as unsuccessful. Based on these data, surgical success rates were found in 38 (86.4%) patients in external DCR and 27 (73%) patients in endonasal DCR. Surgical failure rates were 6 (13.6%) in external DCR and 10 (27%) in endonasal DCR. There was no statistically significant difference between success rates and recurrences in both groups. (p> 0.05).
Conclusions: Endoscopic DCR produced a simple, minimal invasive and preferable results compared to external DCR in Turkish population. Although the success of external DCR is higher and the recurrence is lower than endoscopic DCR, with the outcomes of this study, endoscopic DCR can be tried as the first choice to protect the patient from major surgery and anesthesia in PANDO.

Keywords: Endoscopic endonasal DCR, external DCR, primary acquired nasolacrimal duct obstruction.

Comparison of Success Between External and Endonasal Dacryocystorhinostomy in Primary Acquired Nasolacrimal Duct Obstruction in Turkish Cohort

Bugra Karasu1, Gulunay Kiray2, Erdem Eris1, Irfan Perente1, Ali Riza Cenk Celebi3
1University of Health Sciences, Beyoglu Eye Training and Research Hospital, Istanbul, Turkey
2Umraniye Training and Research Hospital, Department of Ophthalmology, Istanbul, Turkey
3Acibadem University School of Medicine Department of Ophthalmology, Istanbul, Turkey

Amaç: Türk toplumunda, primer kazanılmış nazolakrimal kanal tıkanıklığı(PKNKT) olan hastalarda uygulanan eksternal ve endonazal dakriosistorinostomi(DSR) cerrahisinin sonuçlarını ve rekurrens oranlarını değerlendirmek
Metodlar: Ocak 2010- eylül 2014 yılları arasında Ümraniye Eğitim ve Araştırma Hastanesi göz ve kulak burun boğaz kliniklerinde PKNKT olan hastalarda uygulanan cerrahi sonuçlar retrospektif olarak incelendi. Hastalar postoperatif 1.gün, 1.ay, 3.ay ve 6.ayda takip edildi. Lakrimal drenaj sistemi ve rekurrens oranları ile ilgili bilgiler kayıt altına alındı.
Sonuçlar: Çalışma 81 hastayı içermekte, 27 erkek (33,3%), 54 kadından (66,7%) oluşmaktaydı. Hastaların ortalama yaşı 50.51 ± 12.47 yıldı. Ortalama takip süresi 30.13±16.42 aydı (dağılım 6- 62 ay). Eksternal DSR ve endonazal DSR sırasıyla 44 (66.7%) ve 37 (45.7%) vakadan oluşmaktaydı. Tüm DSR hastalarında lakrimal drenaj yolundaki bütünlük ve açıklık temel alınarak DSR cerrahi sonuçları 3 gruba ayrıldı. 45 (55.6%) başarılı, 20(24.7%) kısmi başarılı ve 16 (19.8%) başarısız olarak sonuçlandı. Bu datalar eşliğinde operasyon başarı oranları eksternal DSR’de 38(86.4 %), endonazal DSR’de ise 27 (73%)hastada bulundu. Cerrahi başarısızlık oranları ise eksternal DSR’de 6 (13.6%), endonazal DSR’ de 10(27%) vakada bulundu. İstatistiksel olarak başarı oranları ve rekürrensler arasında her iki grupta anlamlı bir fark bulunmadı. (p>0.05).
Sonuçlar: Türk toplumunda endoskopik DSR, basit, minimal invaziv ve eksternal DSR’e kıyasla tercih edilebilir sonuçlar verdi. Eksternal DSR’nin başarı oranının yüksek ve nüks oranının düşük olmasına rağmen PKNKT’li hastaları major cerrahi ve genel anesteziden korumak için endoskopik DSR ilk tercih olarak denenebilir. (NCI-2018-0159.R2)

Anahtar Kelimeler: Endoskopik endonazal DSR, eksternal DSR,primer kazanılmış nazolakrimal kanal tıkanıklığı



Corresponding Author: Bugra Karasu
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