Long-term outcomes of endoscopic endonasal conjunctivodacryocystorhinostomy with Jones tube placement: a thirteen-year experience

Abstract

Purpose: To report thirteen years of experience with endoscopic-assisted endonasal primary conjunctivodacryocystorhinostomy (CDCR) and revision with Jones tube placement in Korean patients.

Methods: Thirty-three patients who underwent primary endoscopic endonasal CDCR with a Jones tube and were followed for over 6 months and 22 patients who underwent revision CDCR were retrospectively reviewed. We evaluated the cause of obstruction, operation time, tube length, success rate (at 6, 12 and 24 months), and the cause of failure for primary and revision procedures.

Results: The most common cause for operation in primary CDCR was trauma. The mean operation time was 26 min and 24 min in the primary and revision groups. The initial success rate was 87.9% vs. 74.3% at 6 months postoperative and 63.6% vs. 60% at two years after surgery in the primary and revision group. The most common reason for failure in both groups was medial migration of the tube, and the mean onset of these complications was about 10 months postoperative. Other major reasons for failure were inappropriate length of tube insertion in the primary group and inflammation in the revision group.

Conclusion: Fatal complications which lead to failure may develop many months into the procedure, so long-term follow-up is necessary. The most common cause of failure was medial migration of the Jones tube; however, inappropriate tube insertion in primary surgery and severe inflammation in revision may also be concerns.

Keywords: Cause of failure; Endoscopic endonasal CDCR; Length of Jones tube; Operation time; Primary and revisional surgery; Success rate.