Transcanalicular revision surgery for failed dacryocystorhinostomy

Clin Ter. 2013;164(6):e485-8. doi: 10.7417/CT.2013.1641.

Abstract

Aim: To evaluate the effectiveness of transcanalicular multi diode laser in revision dacryocystorhinostomy and to determine the outcomes.

Materials and methods: Fifty-three consecutive patients (19 males, 44 females) who were referred for recurrent dacryostenosis with epiphora after a failed primary dacryocystorhinostomy (DCR) operation were included in the study. Patients were assigned to two separate groups on the basis of primary DCR operation: either endonasal dacryocystorhinostomy (END-DCR) or transcanalicular multi diode laser dacryocystorhinostomy (TC-MDL DCR). TC-MDL DCR technique was used for revision surgeries in both groups. The mean age of the patients was 46.5 ± 13.1 (Range, 15 -71) and the average follow-up duration was 12 months.

Results: The success rate was 62% (18/29) in the primarily TC-MDL DCR operated group, and 85.2% (29/34) in the primarily END-DCR operated group respectively. The occlusion of internal ostium with granulation tissue was the leading etiology of unsuccessful surgical outcome in both group 1 and group 2 (42.8% and 28.5% respectively).

Conclusions: TC-MDL DCR is a minimally invasive surgical method with relatively high success and low complication rates in patients with failed primary DCR requiring revision.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Dacryocystorhinostomy*
  • Female
  • Granulation Tissue
  • Humans
  • Lacrimal Apparatus Diseases / surgery
  • Laser Therapy*
  • Lasers, Semiconductor
  • Male
  • Middle Aged
  • Minimally Invasive Surgical Procedures
  • Nasolacrimal Duct
  • Nose
  • Reoperation
  • Treatment Failure
  • Young Adult