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At least 1,045 records · Page 58Linked to original sources
PubMed2006

[History of endonasal microsurgery of lacrimal system].

The history and development of surgical treatment of lacrimal system from rhinological point of view was presented. The lacrimal drainage system has provoked great deal of investigation throughout history, because ophtalmologists couldn't attain persistent and permeable drainage between the lacrimal and the nose. The change came, when first Italian rhinologist Toti described external dacryocystorhinostomy (DCR), and later West performed endonasal DCR. The use of microscope and endoscope in rhinosurgery caused the significant progress also in lacrimal surgery. The development of endonasal microsurgery enabled to introduce other non invasive procedure, such as endoscopic laser dacryocystorhinostomy or transcanalicular dacryo-cystorhinostomy (endo-canalicular DCR). One of the newest method in the treatment of complete and partial obstruction of lacrimal drainage system is also baloon dacryocystoplasty.

Dacryocystorhinostomy↗
PubMed1991

[Lacrimal duct obstruction in newborn infants].

Presented is the personal experience concerning the early opening of the occluded lacrimal passages. In 149 newborn babies 4-5 days of age the author performed--according to indications--the syringing and probing of the lacrimal passages with a full success.

Female↗
PubMed1979

[Dacryocytography in traumatology (author's transl)].

Radiological technique in the investigation of the lacrimal system has greatly benefited from various advances in radiology; techniques of catheterisation, contrast media, seriography, subtractions, associated complex tomography (dacryocystotomography), tomodensitometry. To these may be added the dynamic nature of isotope studies (cinegammadacrycystography). These different techniques may be used in the precise analysis of the morphology of the lacrimal system, from the canaliculi to the meatuses. After reviewing normal radiological anatomy, the authors describe morphological abnormalities, according to different forms of obstruction, according to their site. This morphological discovery requires possible changes in technique (additional tomography, for example). The quality of the preoperative morphological exploration influences the quality of the therapeutic results obtained.

Humans↗
PubMed1998

Prospective randomized comparison of external dacryocystorhinostomy and endonasal laser dacryocystorhinostomy.

OBJECTIVE AND DESIGN: The introduction of endonasal laser dacryocystorhinostomy (ENL-DCR) in the early 1990s showed great promise of changing dacryocystorhinostomy into an elegant, minimally invasive procedure from the traditional external dacryocystorhinostomy (EXT-DCR). This prospective, randomized study compares these two operations, their success rates, surgical durations, and postoperative symptoms. PARTICIPANTS: A total of 64 cases in 61 patients with primary acquired nasolacrimal sac or duct obstruction were divided into 2 subgroups by symptoms (simple epiphora and chronic dacryocystitis). These patients were randomized within both subgroups into 2 operation groups with 32 cases in each group. INTERVENTION: Altogether, 32 EXT-DCRs and 32 ENL-DCRs were performed. The silicone tube was removed at 6 months after surgery. The final follow-up visit was at 1 year after surgery. The patency of the lacrimal passage was investigated by irrigation, and patients were questioned about their symptoms. MAIN OUTCOME MEASURES: The patency of the lacrimal passage to irrigation and the duration of surgery were measured. RESULTS: The success rate at 1 year after surgery was 91% for EXT-DCR and 63% for ENL-DCR after primary surgery. The difference was statistically significant (P = 0.016). The surgical duration for ENL-DCR was three times shorter than for EXT-DCR, the average duration being 23 minutes and 78 minutes, respectively (P < 0.0001). CONCLUSIONS: The EXT-DCR, when compared with ENL-DCR, seems to provide superior operation results in primary acquired nasolacrimal duct obstruction.

Adult↗
PubMed2001

Surgical treatment of canalicular stenosis in patients receiving docetaxel weekly.

OBJECTIVE: To describe the surgical treatment and outcomes in patients with metastatic breast cancer and canalicular stenosis caused by weekly treatment with docetaxel. METHODS: This case series included 10 patients with persistent epiphora due to weekly docetaxel treatment, who were evaluated by probing and irrigation of the tear drainage apparatus and were found to have significant canalicular stenosis. The severity of canalicular stenosis was graded clinically. Each patient underwent bicanalicular silicone intubation or dacryocystorhinostomy (DCR) with placement of either a silicone tube (canaliculo DCR) or a pyrex glass tube (conjunctivo DCR). RESULTS: Seven patients (12 eyes) underwent bicanalicular silicone intubation. Three patients (5 eyes) required canaliculo DCR with the placement of a silicone tube. In 2 patients (3 eyes), the degree of canalicular stenosis was severe enough to require conjunctivo DCR with the placement of a pyrex glass tube. All 10 patients had complete resolution of epiphora immediately after surgery. Four patients continued to receive docetaxel after surgery. In patients who underwent bicanalicular silicone intubation, the silicone stent was kept in place for the duration of docetaxel therapy. There were no surgical or anesthesia-related complications. At a mean follow-up time of 9 months after surgery, all but 1 patient (1 eye) remained asymptomatic. The interval between initiation of docetaxel therapy and surgery was significantly higher in patients who required DCR compared with those who had silicone intubation. The mean cumulative dose of docetaxel at the time of surgery was higher in patients who required DCR than in patients who had silicone intubation, but this difference was not statistically significant. CONCLUSIONS: Canalicular stenosis secondary to weekly treatment with docetaxel should be treated with bicanalicular silicone intubation early in the course of docetaxel therapy. Failure to treat this adverse effect early may likely lead to severe and irreversible canalicular stenosis, which may necessitate conjunctivo DCR with the placement of a permanent pyrex glass tube.

Adult↗
PubMed1980

Radiological and histological findings of the lacrimal passages of newborns.

By means of postmortem dacryocystograms and photomicrographs of histological slides, the topography and morphology of the lacrimal passages in premature and mature newborn infants are demonstrated. Because of the bends in the course of the lower tear duct, a percentage of probings will fail to effect satisfactory perforation of Hasner's membrane. In most cases the soft texture of this membrane requires no more than syringing under pressure using a hollow probe.

Dacryocystitis↗
PubMed1982

Study of intranasal ostium external dacryocystorhinostomy.

A rigid endoscope was used to directly examine, measure, and photograph the intranasal ostium created by an external dacryocystorhinostomy (DCR). This technique was used to examine 19 patients who underwent 22 standard external DCRs. All patients had clinically successful results, documented by a positive Jone I dye test following surgery. The dimension of the bony opening created at surgery was measured and averaged 11.84 mm in diameter. The average diameter of the healed intranasal ostium was only 1.80 mm. No statistically valid correlation between the size of the bony opening and the final size of the healed intranasal ostium could be established. Thus, a large surgical anastomosis did not necessarily result in a large healed intranasal ostium. Excellent functional results were obtained even when the intranasal ostium was quite small. Other indications for the use of this technique are discussed.

Dacryocystorhinostomy↗
PubMed2003

Endolacrimal KTP laser-assisted dacryocystorhinostomy.

OBJECTIVE: To describe our experience with potassium-titanyl-phosphate (KTP) laser-assisted dacryocystorhinostomy, controlled via endolacrimal and endonasal endoscopy. The development of miniendoscopes enables endoscopy of the lacrimal drainage system via the lacrimal puncta to visualize the exact site of a stenosis. DESIGN: A case series of 78 patients, with 1-year postoperative follow-up. SETTINGS: A university medical center. PATIENTS: Consecutive sample of 78 adult patients who required surgery for dacryostenosis. INTERVENTION: Endolacrimal use of a KTP laser to perform a bony osteotomy of the lacrimal sac into the nasal cavity. The position for the perforation was controlled by endonasal endoscopy. The procedure was performed under either general or local anesthesia. RESULTS: One year after surgery, 65 (83%) of the 78 patients were free of symptoms. Seven patients experienced intermittent tearing, and 6 had revision surgery because of restenosis. CONCLUSIONS: The success rate of 83% achieved with KTP laser-assisted dacryocystorhinostomy, using miniendoscopes for lacrimal endoscopy to visualize the exact site of obstruction, is better compared with that of prior studies without the use of miniendoscopes (with success rates of 47%-85%). The advantages of this technique are that it is a minimally invasive procedure, requires a short operating time, and avoids use of an external incision.

Dacryocystitis↗
PubMed1995

Punctal and canalicular stenosis associated with systemic fluorouracil therapy. Report of five cases and review of the literature.

Ocular side effects of systemic fluorouracil include excessive lacrimation, due to punctal and canalicular stenosis and fibrosis. Obstruction of the tear ducts after systemic therapy with fluorouracil is more frequent than is assumed. Five patients with breast cancer and punctal or canalicular stenosis are presented. Although complaints of epiphora usually resolve two weeks after cessation of systemic therapy, local antibiotics and steroids may be indicated. In patients with persisting complaints, and patients treated with fluorouracil for a prolonged period of time, prophylactic intubation of the tear ducts with silastic tubes has been advocated. (Conjunctivo)dacryocystorhinostomy may be unavoidable.

Aged↗
PubMed1980

Relationship of septal deformity to snuffly noses, poor feeding, sticky eyes and blocked naso-lacrimal ducts.

Septal deformity is part of a facial deformity and is considered to be due to a combination of irregular developmental growth of the palatal folds, and external pressure on the maxilla, during pregnancy or parturition. The incidence and types of septal deformity in 2380 Caucasian births are compared with those of 2112 adult skulls of different ethnic groups. The close association of septal deformity with snuffliness, disturbed feeding and sticky eyes, and the relief of symptoms by manipulation of the palate and septum is described. Puffy eyes are due to severe birth pressures and may lead to moist, then sticky, then infected eyes. This occurs 2 to 3 days after birth and is to be distinguished from the severe eye infections in the first 24 h from contamination at birth. A high incidence of septal deformity occurs in sticky eyes and a close association with the type of deformity and the side of the infection has been found. The presence of septal deformity and the close correlation with the affected side has been found in every case (100%) of continued epiphora requiring probing and syringing of the naso-lacrimal ducts (NLDs). Manipulation of the palate and septum, often with medial dislocation of the anterior end of the inferior turbinates, has been of considerable help in the treatment of continued epiphora. Some aetiological factors in NLD obstruction are described.

Eye Diseases↗