The importance of clinical presentation on long-term outcomes of external dacryocystorhinostomies: Our experience on 245 cases
| Autor: | Antonio Giordano Resti, Luisa Mattalia, Umberto Tanzini, Alessandro Bordato, Alessandro Vinciguerra, Andrea Rampi, Francesco Bandello, Matteo Trimarchi |
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| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
medicine.medical_treatment Lacrimal pathway Cicatrix Dacryocystitis External dacryocystorhinostomy Lacrimal Duct Obstruction medicine Long term outcomes Humans Statistical analysis Chronic dacryocystitis Aged Retrospective Studies Surgical approach business.industry Stent Endoscopy General Medicine Surgery Ophthalmology Treatment Outcome Presentation (obstetrics) business Dacryocystorhinostomy Nasolacrimal Duct |
| Zdroj: | European journal of ophthalmology. 32(5) |
| ISSN: | 1724-6016 |
| Popis: | Purpose External dacryocystorhinostomy (EXT-DCR) is a surgical approach commonly used to treat post-canalicular acquired lacrimal obstruction whose success rate has been described, equally with endoscopic DCR, to be superior to other available treatments. Methods At San Raffaele Hospital, Milan (Italy), from January 2008 to December 2020, 245 EXT-DCRs were performed. All patients underwent routine pre-operative work-up including Jones tests and probing and irrigation of the lacrimal pathway; when necessary, a multidisciplinary approach with nasal endoscopy was performed. The surgical approach was followed by positioning of a bicanalicular stent which was left in place for 6 months. Success was defined as resolution of clinical signs/symptoms and free lacrimal flow on functional test. Results Of the cases enrolled, 26.9% were treated for recurrent epiphora (group 1), and 73.1% for epiphora associated with chronic dacryocystitis (group 2). After a median follow-up of 71 months, group 1 had success at T0 (1 month) and T1 (long-term) of 81.8% and 60.6%, respectively, compared to 93.8% and 77.7% in group 2. Statistical analysis showed a significant association with surgery both at T0 ( p = 0.018) and T1 ( p = 0.012) with group 2 showing better outcomes. Additionally, the cosmetic outcome of the external scar was defined as invisible in 91.8% of cases and slightly visible in 8.2%. Conclusions External dacryocystorhinostomy provides long-term reliable results particularly in case of chronic dacryocystitis. Moreover, the optimal esthetic outcome of the external scar should be no longer considered the only guiding principle of treatment modality, particularly in the elderly. |
| Databáze: | OpenAIRE |
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