PDF(Pubmed)
Abstract：
Introduction This is a comparative cross-sectional study done to compare the curative outcome of endonasal dacryocystorhinostomy (DCR) done with and without a silicon stent in patients with chronic dacryocystitis due to nasolacrimal duct obstruction. Methods This study was carried out in central India, involving 60 patients who were diagnosed with chronic dacryocystitis and underwent endonasal DCR (with zero-degree and 45-degree endoscopes from Olympus, with an Olympus camera and monitor) between October 2021 and September 2022. All patients were over the age of 18, with major exclusion criteria of previous DCR and sinonasal disease. All the surgeries were done by the same senior surgeon, in which 30 patients were stented (with a Prison silicone nasolacrimal duct stent) and 30 of them were non-stented. The follow-up duration for these was 12 months after the surgery. Results The outcome was evaluated at the end of three months, six months, and 12 months for both groups (patients with and without stents) using the Chi-square test. The success rate at the end of six months was 90% with stented patients and 93.3% with non-stented patients (p-value - 0.64); at six months, it was also the same (p-value - 0.64); and at the end of 12 months, it was 80% and 76.6% (p-value - 0.71) for patients with and without a stent, respectively. The final endoscopy at the end of 12 months showed 93.3% of patients who underwent stenting had a patent rhinostomy opening, and 90% of those who were not stented had a patent opening. Conclusions Our observational comparative study showed that patients with chronic dacryocystitis who underwent endonasal DCR with and without stenting had almost similar results. There was no significant difference in the outcome. So, we concluded that generally all the patients should be considered for endonasal DCR without a stent, except in special cases like revision endonasal DCR, lacrimal gland cysts, fistulas, and patients with sinonasal pathology, in whom silicon stents can be preferred.
摘要：
简介这是一项比较性横断面研究，旨在比较鼻泪管阻塞导致的慢性泪囊炎患者使用和不使用硅支架进行鼻内泪囊鼻腔吻合术（DCR）的疗效。方法本研究在印度中部进行,包括60例被诊断为慢性泪囊炎并接受鼻内DCR的患者（使用Olympus的零度和45度内窥镜，在2021年10月至2022年9月之间配备奥林巴斯相机和显示器）。所有患者年龄均在18岁以上，主要排除标准为既往DCR和鼻窦疾病。所有的手术都是由同一个高级外科医生完成的，其中30例患者进行了支架治疗(使用Prison硅胶鼻泪管支架),其中30例患者未进行支架治疗。术后随访时间为12个月。结果在三个月结束时评估结果。六个月,两组（有和没有支架的患者）使用卡方检验12个月。在六个月结束时，支架患者的成功率为90％，非支架患者为93.3％（p值-0.64）；在六个月时，也是一样的(p值-0.64)；在12个月结束时，有和没有支架的患者分别为80％和76.6％（p值-0.71），分别。在12个月结束时的最终内窥镜检查显示，93.3％的患者接受了支架置入术，90%没有支架的人有专利开放。结论我们的观察性比较研究表明，慢性泪囊炎患者接受有或没有支架置入的鼻内DCR的结果几乎相似。结果没有显着差异。所以,我们得出的结论是，通常所有患者都应考虑在没有支架的情况下进行鼻内DCR，除了在特殊情况下，如修订鼻内DCR，泪腺囊肿,瘘管,有鼻窦病理学的病人,其中硅支架可以是优选的。
