Abstract:
Objective: To compare endoscopic dacryocystorhinostomy (EnDCR) with and without silicone lacrimal stenting through subjective (patients\') and objective (surgeons\') outcome parameters. Methodology: Following defined selection criteria, EnDCR was performed on patients with primary chronic dacryocystitis with post-saccal stenosis. Every alternate patient had silicone lacrimal stenting (group A: no stenting; group B: with stenting); stents were removed at three months. At six months (minimum follow-up period), patients\' responses on symptom relief (through a five-point score) and naso-endoscopic evaluation (visualization of rhinostome; presence of granulations and synechiae; lacrimal drainage patency by estimating methylene blue flow pattern) were compared between the groups. Results: Each group had 20 patients. There was no statistically significant difference in group-wise follow-up periods. Five-point score at six months revealed 85% and 95% of patients in groups A and B, respectively, experienced \"success\"; among them, 60% and 75% were \"symptom-free\". The majority (75%) in group B experienced no discomfort from stenting. Naso-endoscopy revealed 80% patients in group A and 65% in group B had well-delineated rhinostome, albeit with granulations in 25% and 50%, respectively. Spontaneous dye flow was achieved, respectively, in 75% and 90%. The difference in none of the subjective and endoscopic parameters achieved statistical significance. None had synechia; fibrosis was seen in the four patients with no dye flow even with pressure/massaging. Conclusion: There was no statistically significant difference in EnDCR with and without silicone lacrimal stenting in the overall outcome of symptomatic improvement and endoscopic assessment of the surgical site.
摘要:
目的:通过主观(患者)和客观(外科医生)结果参数,比较内窥镜泪囊鼻腔吻合术(EnDCR)有无硅胶泪道支架置入术。方法论:遵循定义的选择标准,EnDCR是对原发性慢性泪囊炎合并囊后狭窄的患者进行的。每位备用患者都进行了硅胶泪道支架置入术(A组:无支架;B组:有支架);支架在三个月时取出。在六个月(最低随访期),在两组之间比较了患者对症状缓解(通过5分)和鼻内镜评估(鼻窦可视化;存在颗粒和粘连;通过估计亚甲蓝流型来进行泪管引流通畅)的反应.结果:每组20例。分组随访期间差异无统计学意义。6个月时的5分评分显示A组和B组分别有85%和95%的患者,分别,经历过“成功”;其中,60%和75%为“无症状”。B组中的大多数(75%)没有因支架置入而感到不适。鼻内窥镜检查显示,A组中80%的患者和B组中65%的患者均有良好的鼻列,尽管颗粒在25%和50%,分别。实现了自发的染料流动,分别,75%和90%。主观和内镜参数的差异均无统计学意义。没有人粘连;四名患者即使有压力/按摩也没有染料流,可见纤维化。结论:在手术部位的症状改善和内窥镜评估的总体结果中,使用和不使用硅胶泪道支架的EnDCR没有统计学上的显着差异。