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Results for “DACRYOCYSTITIS”

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At least 379 records · Page 21Linked to original sources

PubMed1997

Balloon dacryocystoplasty: indications and contraindications.

PURPOSE: To define the indications and contraindications for balloon dacryocystoplasty. MATERIALS AND METHODS: Eighty-five patients with severe epiphora due to partial (n = 47) or complete (n = 38) obstruction of the nasolacrimal duct (NLD) were treated with balloon dacryocystoplasty (DCP). Steerable micro-guide wires with flexible tips were used. Success rates of DCP were evaluated clinically and dacryocystographically during the acute phase and at 6- and 12-month follow-up. Failures and recurrences were correlated with clinical and dacryocystographic indications for treatment. RESULTS: Recanalization was successful in 35 (92%) of 38 patients with isolated focal stenoses (n = 20) or short-distance occlusions (n = 18) of the NLD. Among all 85 patients, recanalization was successful in 25 patients (66%) with complete and 37 patients (79%) with partial obstructions. In the absence of the main predictors for recurrent obstructions (ie, active inflammation, filling defects due to calculi, long-distance occlusions, and posttraumatic lesions), 12-month patency rates were 89% (17 of 19 focal stenoses) and 94% (15 of 16 focal occlusions). Otherwise, reobstruction rate was 46% (12 of 26 cases). CONCLUSION: Balloon dacryocystoplasty is successful only in select cases. To achieve results comparable to those of operative treatment, the indication should be limited to patients with circumscribed focal stenoses or occlusions of the NLD. Active dacryocystitis, dacryocystolithiasis, and posttraumatic lesions are the main contraindications.

Catheterization↗

PubMedDate not supplied

Stenosis of the lachrymal system in Rubinstein-Taybi syndrome.

In this article the authors describe a case of atypical stenosis of the lachrymal excretory system in Rubinstein-Taybi syndrome (RTS) characterised by morphologic anomalies of the lachrymal bag and by alterations of the osseous structure of the nose. A 9-year-old girl, with typical findings of RTS, was affected by recurrent acute dacryocystitis and tearing. Ocular examination revealed bilateral reflux with mucous and purulent material flowing back after digital pressing: low and bilateral nose-lachrymal duct obstruction was the main cause of the reflux as confirmed by orifice probing, lachrymal drainage system irrigation and spiral CT examination using hydrosoluble contrast medium. The multiplanar reconstruction obtained from CT scanning shows that the right lachrymal sac has an abnormal shape ('grape-bunch' image) and that the left one has various bulgings, or swellings, in its shape. The 'grape-bunch' lachrymal bags are the most unusual features of our patient's lachrymal system and it is important to consider the difficulties that could occur during surgery because of the abnormal bag shape and because of the increased bone thickness in RTS patients. The 'grape-bunch' lachrymal sac is a truly unusual anatomical feature and, most probably, it could be distinctive of this syndrome.

Child↗

PubMedDate not supplied

Nasolacrimal drainage system cyst in an adult.

A cyst of the nasolacrimal drainage system (NLDS) is rare in an adult. We report a case in a 29-year-old man of a mucous retention cyst of the NLDS, which appeared 2 years after the patient developed dacryocystitis coincident with an aggravation of chronic sinusitis. The lesion was successfully managed by removing the bony wall of the NLDS at the interface with the ethmoid and nasal cavity, as well as the membranous closure of the ostium of the common canaliculus. We speculate that the cyst development might have been initiated by inflammatory change such as mucosal adhesion in the NLDS resulting from the spread of secondary infection from the sinonasal tract.

Adult↗

PubMed1997

Parameter estimation and dosage adjustment in the treatment with vancomycin of methicillin-resistant Staphylococcus aureus ocular infections.

The susceptibility of methicillin-resistant Staphylococcus aureus (MRSA) to vancomycin (VC) is excellent, but excessive dosing of VC leads to severe side effects. In this study, we present a way of administration planning for each patient based on personal data. To this end, we employed the Sawchuck-Zaske equation to calculate VC clearance (CL) and volume of distribution (Vd) on the basis of three different plasma concentrations of VC, and we used CL and Vd values as prior information before employing the parameter estimation and dosage adjustment program to treat a patient with postsurgical endophthalmitis caused by MRSA and a patient with acute dacryocystitis also caused by MRSA. They had good remissions without any severe side effects.

Acute Disease↗

PubMed2003

Hammer-chisel technique in endoscopic dacryocystorhinostomy.

We performed a prospective evaluation of endoscopic hammer-chisel dacryocystorhinostomy (DCR) procedures on 62 eyes of 44 patients (40 female and 4 male) with chronic epiphora or dacryocystitis (26 unilateral and 18 bilateral). The technique included chisel removal of bone over the lacrimal sac. The follow-up period was 12 to 54 months (mean, 28 months), and the patients' ages ranged from 17 to 67 years (mean, 35.5 years). The success rate of the consecutive endoscopic hammer-chisel DCR procedures was 87%. During operation, 8 patients had mild mucosal hemorrhage, which did not prevent the successful completion of the operation. Excellent patient tolerance was observed, with minimal morbidity and no major complications. As compared to the external approach, endoscopic hammer-chisel DCR is less traumatic, is less time-consuming, and is practical and cosmetically convenient, with minimal perioperative and postoperative complications. It also allows the simultaneous correction of any intranasal disease. It requires minimal instrumentation and is a relatively easy and fast technique.

Adolescent↗

PubMedDate not supplied

Repeated probing results in the treatment of congenital nasolacrimal duct obstruction.

PURPOSE: To assess the results of our protocol of repeated probing for the treatment of congenital nasolacrimal duct obstruction in various presentations. METHODS: A total of 1600 patients (1748 eyes) with congenital dacryocystitis (850 boys, 750 girls; age range, 1 month to 48 months [mean 16.54 +/- 12.21 months]) were included. Diagnosis was confirmed by history of tearing, crusting of lids, and a boggy swelling over inner canthal region, which on pressure ejected mucopurulent discharge through punctum. Antibiotic eye drops were instilled five times a day for a week in affected eyes after the mother pressed the sac area and cleaned the discharge. The cases that were not relieved were subjected to sequential probing dilating with an increasing diameter probe repeated in failed cases second and third times at 1-week interval. RESULTS: Medical treatment was effective in only 60 eyes (3.43%). Probing and syringing achieved successful results in 790 eyes (100%) aged 1 month to 12 months; 330 eyes (99.40%) aged 12 months to 18 months; 200 eyes (98%) aged 18 months to 24 months; 150 eyes (95.24%) aged 24 months to 36 months; and 158 eyes (89.87%) aged 36 months to 48 months. The cure rate with first probing was 98.10%, second probing was 99.64%, and third probing was 100%. CONCLUSIONS: Our protocol of medical regime and early probing repeated two to three times was very effective in the treatment of nasolacrimal duct obstruction at all ages. A second and third probing was recommended after 1 week of the first probing with successful results if first probing failed.

Acute Disease↗

PubMed1982

Twenty years experience with intranasal transseptal dacryocystorhinostomy.

The intranasal transeptal approach for treating chronic dacryocystitis has been utilized by the authors since 1959. A total of 305 operations have been performed with a high success rate and very low complication rate. The intranasal approach is preferred since it allows good visualization of the lacrimal sac, avoids a facial scar, and is most successful. Two hundred and eighty-four primary operations were performed with an 89% success. Of 29 failures, 25 were re-operated on with only 2 failures. Counting patients who required a revision operation, the overall success rate was 99%. Most revisions had to be performed because of scar formation in the nose or bony regrowth over the nasal opening. Complications were few with two patients having postoperative bleeding requiring nose to be repacked, two small septal perforations, one periorbital abscess and one case in which there was severe scar formation in the nose.

Adolescent↗

PubMed1985

CT of the inferomedial orbit and the lacrimal drainage apparatus: normal and pathologic anatomy.

The normal and pathologic CT anatomy of the lacrimal drainage apparatus was examined during study of the orbits, nasal cavity, and paranasal sinuses in 100 patients with a variety of clinical complaints related to the inferomedial orbit. The bony lacrimal fossa, the nasolacrimal canal, and the fluid- or air-filled lacrimal sac and nasolacrimal duct were readily recognized in all cases. The lacrimal fossa and sac are found at the inferomedial orbit and are preseptal structures. Cystic expansion of the lacrimal sac (dacryocystitis) may mimic orbital abscess clinically; however, the radiographic recognition of a cystic, peripherally enhancing mass centered at the lacrimal fossa should exclude postseptal abscess and permit more conservative therapy. Obstruction or invasion of the drainage apparatus by tumor, infection, or posttraumatic scarring is readily depicted by CT. Sagittal/coronal images reformatted from thin transverse axial sections are often useful in defining the origin of an inferomedial orbital mass and its relation to the lacrimal sac when clinical studies and axial CT findings are equivocal.

Adult↗

PubMed1997

Four cases of dacryocystocele.

Dacryocystocele is a rare complication of chronic dacryocystitis. We report four such cases in which epiphora and painless cystic mass located inferior to the medical canthus were manifested. Computed tomographic scanning of the orbit showed a well-demarcated low density mass in the lacrimal sac area, and extending to the nasolacrimal duct. We completely or partially excised the mass and depending on the condition of the canaliculi and puncta, performed dacryocystorhinostomy, canaliculorhinostomy, or conjunctivodacryocystorhinostomy using Jones' tube. Operative findings revealed that the lacrimal sac and nasolacrimal duct were dilated with obliterated proximal and distal portions the cyst. When cysts in the lacrimal sac area develop subsequent to chronic epiphora or are accompanied by punctal agenesis, differential diagnosis should consider the possibility of dacryocystocele.

Adult↗

PubMedDate not supplied

Visual loss following dacryocystectomy.

Dacryocystectomy is the surgery of choice for elderly patients with chronic dacryocystitis with a fibrotic sac. Although a simple procedure, it can cause serious complications (however rare) such as visual impairment. A 65-year-old woman who underwent bilateral dacryocystectomy is described. On the first postoperative day, she complained of pain in her left eye. Her visual acuity was light perception in the left eye. Computed tomography scan of the orbit revealed a retrobulbar hematoma on the left eye. The hematoma was drained, but the patient did not regain vision. A rare complication of visual loss following dacryocystectomy is described.

Aged↗

PubMed1994

Lacrimal disease.

Several authors have investigated the success of nasolacrimal duct intubation in children as well as the length of time for tubes to remain in place. The treatment of congenital amniocele with potential for life-threatening septicemia has been investigated. Other topics have included the bacteriology of dacryocystitis emphasizing the risk of endophthalmitis after intraocular surgery, balloon treatment for functional nasolacrimal duct obstruction, anatomical measurements of the lacrimal system relative to intracranial space, and new procedures for punctal stenosis. Diagnostic tests for epiphora and methods of punctal occlusion are evaluated.

Dacryocystitis↗

PubMed1997

[Laser transnasal dacryocystorhinostomy under head mirror].

Laser transnasal dacryocystorhinostomy under head mirror is a new approach for surgical treatment of chronic lacrimal obstruction. This technique has several advantages, such as less damage, less operative complications and so on. This paper presented the results of 37 cases who had undergone transnasal dacryocystorhinostomy for chronic dacryocystitis under head mirror. The postoperative follow-up time was 3-24 months. The effective rate was 95.6%. The operative technique was also discussed in this paper.

Adolescent↗

PubMed2000

[Sarcoidosis: acute versus chronic--2 case reports].

Sarcoidosis manifests itself with different symptoms and can thereby follow an acute or chronic course. We will discuss one case each. Case 1 involves a 41-year-old patient with Loefgren's syndrome, showing the typical trias of erythema nodosum, bilateral hilar lymphadenopathy and acute polyarthritis. With systemic steroid treatment the symptoms disappeared rapidly. In case 2 we present a 39-year-old-man with chronic sarcoidosis for several years with no vital threat. His organ involvement includes chronic dacryocystitis. Systemic steroids relieved his symptoms and the dacryo-rhinostomy could perhaps have been prevented had the therapy been started earlier. Evaluating the diagnostic and therapeutic procedure can be difficult because there are no standard guidelines. A vital threat demands rapid diagnosis and effective therapy. The chronic illness requires a thorough evaluation of the appropriate therapy. We discuss the criteria for diagnosis, therapy and follow up.

Acute Disease↗

PubMed2000

Infusional floxuridine-based therapy for patients with metastatic renal cell carcinoma.

BACKGROUND: The treatment of patients with metastatic renal cell carcinoma (RCC) continues to pose a major clinical challenge. Previous studies have suggested that infusional floxuridine (FUDR) has antitumor efficacy and is well tolerated. To the authors knowledge the combination of infusional FUDR with biologic response modifiers (BRMs) has not been evaluated extensively in patients with metastatic RCC. METHODS: Thirty-nine previously untreated patients with metastatic RCC were treated with infusional FUDR at 0.075 mg/kg/day for 14 days of a 28-day cycle. Beginning with the second cycle of FUDR, 24 patients received subcutaneous interferon-alpha-2b (3 million U 3 times a week for Weeks 1 and 2) and 15 received subcutaneous interleukin-2 (IL-2) (5 million U/m(2) 5 days a week for 3 weeks, followed by 1 week off). The dose of FUDR was increased by 0.025 mg/kg each cycle until the maximum tolerated dose for each patient was reached. RESULTS: Five patients receiving FUDR plus interferon achieved a partial response and 1 achieved a complete response whereas 3 patients receiving FUDR plus IL-2 achieved a partial response, for an overall response rate of 23%. The median survival for all patients was 21 months, and 8 patients still were alive 6-57+ months after the initiation of therapy. Toxicity was mild to moderate, and was comprised primarily of fatigue, diarrhea, dacryocystitis, and fluid retention (in the IL-2 cohort). CONCLUSIONS: FUDR in conjunction with IL-2 or interferon appears to produce response rates comparable to those observed with other programs utilizing BRMs and generally is well tolerated. FUDR regimens may be useful in the treatment of metastatic RCC in the outpatient community setting.

Adult↗

PubMedDate not supplied

Nasolacrimal duct foreign body--endoscopic removal.

Foreign body in the nasolacrimal duct is extremely rare. We present a case of foreign body of nasolacrimal duct responsible for recurrent dacryocystitis which was removed with the help of an endoscope.

Adolescent↗

PubMed2000

Endonasal microscopic dacryocystorhinostomy: results and advantages.

BACKGROUND: The modern endonasal operative technique of functional fenestration of saccus lacrimalis in the middle nasal meatus (endonasal dacryocystorhinostomy), first described by West in 1910, has been gaining in significance over the past few years. At the VI National Congress of Otorhinolaryngology (1997) we presented for the first time in this country performance of endonasal microscopic dacryocystorhinostomy videotaped and started a routine use of this technique in our department. OBJECTIVE: We present the results of our 3-year experience with the technique. MATERIAL AND METHODS: Endonasal microscopic dacryocystorhinostomy was performed in 50 patients (57 operations) without stenting. The effect of the surgery was assessed by comparing the results of control examinations with the preoperative findings using the following criteria: subjective complaints, and objective findings--palpatory test, irrigation according to Anell, endoscopy of the nasal cavities and the neo-ostium. RESULTS: Statistically significant improvement of specific subjective symptoms was obtained in 78.9%-100%. In 6 cases the closure of the neo-ostium was proven endoscopically. CONCLUSION: Endonasal microscopic dacryocystorhinostomy preserves intact the normal function of the lacrimal pump, yields excellent cosmetic results and allows simultaneous management of the concomitant sino-nasal pathology. A neo-ostium under 2 mm in diameter can be conducive to postoperative epiphora. A congenital, untreated form of postsaccal stenosis with concomitant dacryocystitis as well as formation of synechiae are factors increasing the possibility of restenosis.

Adolescent↗

PubMed1975

Dacryocystorhinostomy with nasolacrimal duct prostesis.

For many years the standard surgical treatment for chronic dacryocystitis has been the anastomosis of the lacrimal sac mucosa to nasal mucosa over the margins of an ostium through the lacrimal bone. Failures of this standard procedure have been attributed to many factors and complications frequently require reoperation. The procedure described in this paper was developed as one means of overcoming some of these difficulties. It consists of the implantation of a specially shaped nasolacrimal duct prosthesis from the base of the sac through the interosseous canal into the inferior nasal meatus. This procedure gives reasonable assurance of permanent drainage and is recommended as a primary procedure of choice. The operation is described.

Chronic Disease↗

PubMed2001

[Eye disease in painters--Camille Pissaro].

Some vision disorders to painters have influenced their work. Camille Pissarro the dean of impressionism, presented from forty-eight years dacryocystitis on his left eye and ipsilateral conjunctive chemosis temporally. In that time the treatment consisted in incision and drainage of the lacrymal sac, and cauterization. Due this chronic disease he was forced to paint inside, behind closed windows, in order to avoid dust and wind. This situation influenced the subjects of his painting. His painting reflects large crowds Paris avenues and buildings. This is characteristic for his wonderful works.

Dacryocystitis↗