| Popis: |
Dacryocystorhinostomy is an advanced method of surgical treatment of obstruction of the distal part of lacrimal duct. In spite of the high degree of success of the primary surgery, there remains a probability of recurrent obstruction and the necessity of revision surgery. In that article we present our clinical experience of endoscopic endonasal dacryocystorhinostomy (End-DCR). Objective: To assess End-DCR efficacy in the treatment of stenosis of the distal parts of lacrimal system in the patients with primary endoscopic intervention and revision surgery. Materials and methods: The authors conducted a retrospective analysis of clinical data of 106 patients (9 men (10.7%), 97 women (89.3%) with nasolacrimal duct obstruction, who underwent endoscopic endonasal dacryocystorhinostomy in the Otorhinolaryngology Clinic of Pavlov First Saint Petersburg State Medical University at the period of September, 2014 through September, 2017. The study group included both the patients with the primary endoscopic intervention and the patients with revision surgery. Results: in the group of primary surgical interventions, End-DCR was effective in 98 patients (92.5%). In 8 (7.5%) patients the surgical treatment was ineffective. Such patients were recommended a revision surgery with the installation of a bicanalicular silicone stent. In catamnesis, no recurrent stenosis of the nasolacrimal duct was observed in most patients (87.5%). Conclusions: The experience of our Chair proves the high efficacy of endoscopic endonasal dacryocystorhinostomy in the treatment of patients with nasolacrimal duct obstruction distally from the lacrimal sac, both in the primary and in the revision surgery. It is important to determine the cause of closure of neoanastomosis in patients with unsuccessful outcome of primary End-DCR and, based on these data, choose a revision surgery method, which can improve the ultimate index of success of the operation. |
