Universität zu Köln

Mor, Joel M., Matthaei, Mario, Schrumpf, Holger, Koch, Konrad R., Boelke, Edwin and Heindl, Ludwig M. (2018). Transcanalicular laser dacryocystorhinostomy for acquired nasolacrimal duct obstruction: an audit of 104 patients. Eur. J. Med. Res., 23. LONDON: BMC. ISSN 2047-783X

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Abstract

Purpose: External dacryocystorhinostomy (DCR) is considered as the gold standard in the treatment of acquired nasolacrimal duct obstruction. However, many advances have been made towards the development of modern minimally invasive therapies. These new techniques were proven less harmful to the patients' skin and medial palpebral structures with their palpebral-canalicular pump mechanism. Options include endonasal and transcanalicular procedures. Here, we report on our 2-year experience with the surgical technique, results and complications of transcanalicular laser-assisted DCR. Methods: This is a retrospective study. A total of 104 patients with acquired nasolacrimal duct obstruction underwent transcanalicular laser-assisted DCR combined with bicanalicular silicon intubation. We then analyzed intra-/post-operative complications and subjective and objective success rates. The institutional ethics committee ruled that approval was not necessary. The trial was registered with the German Clinical Trials Register (DRKS00012879). Results: Transcanalicular laser-assisted DCR in combination with bicanalicular silicon intubation could be performed surgically successfully in 101 patients (97%). In three cases (3%) using the superior canalicular approach, positioning of the laser instrument at the anteroinferior rim of the middle turbinate failed. Complications included thermal injury to the canaliculus (one), canalicular infection (two) and silicon tube prolapse (ten). Functional success (resolution of pre-operative symptoms) was achieved in 80 cases (77%), functional failure occured in 24 cases with all patients reporting persisting epiphora, 15 reporting failure to irrigate the nasolacrimal duct and 15 requiring secondary external DCR. Conclusions: Laser-assisted DCR shows promising results with few complications. It seems well suited as a second-step procedure after failed recanalization and before external DCR.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Mor, Joel M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Matthaei, Mario UNSPECIFIED UNSPECIFIED UNSPECIFIED Schrumpf, Holger UNSPECIFIED UNSPECIFIED UNSPECIFIED Koch, Konrad R. UNSPECIFIED UNSPECIFIED UNSPECIFIED Boelke, Edwin UNSPECIFIED UNSPECIFIED UNSPECIFIED Heindl, Ludwig M. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-165633
DOI:	10.1186/s40001-018-0355-4
Journal or Publication Title:	Eur. J. Med. Res.
Volume:	23
Date:	2018
Publisher:	BMC
Place of Publication:	LONDON
ISSN:	2047-783X
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language DIODE-LASER; EXTERNAL DACRYOCYSTORHINOSTOMY; ENDONASAL DACRYOCYSTORHINOSTOMY; ASSISTED DACRYOCYSTORHINOSTOMY; SURGICAL TECHNIQUE; DCR; MANAGEMENT; SURGERIES; SILICONE Multiple languages Medicine, Research & Experimental Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/16563