Usefulness of the dacryoscintigraphy in patients with nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy

Graefes Arch Clin Exp Ophthalmol. 2019 Jul;257(7):1535-1540. doi: 10.1007/s00417-019-04303-4. Epub 2019 Apr 29.

Abstract

Purpose: To evaluate the clinical usefulness of the dacryoscintigraphy in patients with nasolacrimal duct obstruction prior to endoscopic dacryocystorhinostomy.

Methods: One hundred thirty-five lacrimal views of endoscopic dacryocystorhinostomy (DCR) with a single surgeon for primary nasolacrimal duct obstruction (PANDO) were included. These were assigned into three groups according to the type of dacryoscintigraphy. Group 1 was a pre-sac obstruction pattern. Group 2 was an intra-sac obstruction pattern. Group 3 was post-sac obstruction pattern. Each group was evaluated for an anatomical and functional surgical success, presence of complications including granuloma, synechiae, and tube-induced inflammation at least 12 months after the surgery.

Results: Both anatomical and functional success rate showed no significant difference among the three groups (P = .297 and .472 linear by linear association). Functional failure rate (functional failure/total failure) also showed no clinically significant differences between groups. Logistic regression analysis was performed to determine the factors associated with functional success. There were no statistically significant factors in age, sex, scintigraphy type, pre-operative endoscopic grade, post-operative granuloma, and synechiae.

Conclusion: In patients with nasolacrimal duct obstruction, preoperative evaluation of obstruction level using dacryoscintigraphy may be not useful for predicting the functional success of the endoscopic dacryocystorhinostomy.

Keywords: Dacryocystography; Endoscopic dacryocystorhinostomy; Lacrimal scintigraphy; Nasolacrimal duct obstruction.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Dacryocystorhinostomy / methods*
  • Endoscopy / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Lacrimal Apparatus / diagnostic imaging*
  • Lacrimal Apparatus / surgery
  • Lacrimal Duct Obstruction / diagnosis*
  • Male
  • Middle Aged
  • Nasolacrimal Duct / diagnostic imaging*
  • Nasolacrimal Duct / surgery
  • Preoperative Care / methods*
  • Prognosis
  • Radionuclide Imaging / methods*
  • Reproducibility of Results
  • Retrospective Studies
  • Severity of Illness Index