Pdf clinical outcome of endonasal ktp laser assisted. Tsirbas and wormald are to be congratulated on their landmark paper in lacrimal surgery describing endonasal dacryocystorhinostomy dcr with mucosal flaps, 1 which is also known as powered endonasal dcr. Recently, advanced approaches utilizing tissue damage, the preservation. Despite much debate, many still believe that external dcr provides a high success rates than endoscopic dcr though many types of endonasal approaches have been attempted, long term success rates are less than ext. It allows capturing images with an extremely high resolution and a 75. This is a new technique that involves creation of a large rhinostomy and mucosal flaps. Early results with the endoscopic dcr were not as good as the best results. Longterm results of endonasal dacryocystorhinostomy.
This requires removal of the small amount of bone that lies between your tear sac and your nose. This video demonstrates endoscopic dcr performed on a 57yearold female. Endonasal cranial correction advanced biostructural. Be sure that the net service is located in services. Endolacrimal ktp laserassisted dacryocystorhinostomy. The main argument for an endonasal approach is the lack of a scar. The endonasal dcr technique uses a fberoptic probe inserted in the punctum for guidance. A questionnaire was applied to patients preoperatively, and.
Fifty patients who underwent ext or enddcr between january 20102012 were involved in the study. Digital journal of ophthalmology 2015 volume 21, number 3 september 20, 2015 doi. Ct eartemporal bonepetrous ridges mercy medical center. We analyzed the results of 173 patients who underwent an. This included three patients with postoperative hemorrhage two who had endonasal dcr surgery and one having external dcr surgery. External dacryocystorhinostomy dcr is the most common and wellknown surgical method to restore the nasolacrimal system. It can be done with external ex or endonasal en access.
In good hands however, the scar is very inconspicuous. Packaged in singleuse centrix syringe tips, accessflo saves time while eliminating crosscontamination. Endonasal dcr was first completed in 1958 with the use of a microscope, and later the procedure used endoscope systems and lasers. Bicanalicular silicone stents in endonasal dcr american. Pdf endonasal dacryocystorhinostomy dcr without flap and. Citrix fahig, unterstutzt pdf hintergrunde, wasserzeichen, als pdf netzwerk drucker. Published success rates for external dcr, endonasal dcr and endocanalicular laser dcr range widely from 50% to 99%.
Abc endonasal cranial correction ecc is a proven and effective method that helps bring the body back into alignment through the correction of cranial bones out of place in a direction the body cannot selfcorrect. An assessment of those significant reports about dcr techniques. Long term success of endodcr with silicone tube catheter. Complication rates were low in both types of surgery. Endonasal dcr may be useful in the management of acute dacryocystitis with abscess formation,10, 58 unlike external dcr, which is often considered to be contraindicated in this setting. Dacrocystorhinostomy dcr is an operation used to treat nasolacrimal duct obstruction. Endoscopic endonasal dacryocystorhinostomy dcr is the best, scar free no scar, lacrimal surgery performed for restoration of tears flow into the nose from the lacrimal sac, when the nasolacrimal duct tear duct has become blocked blocked tear duct tear duct obstruction.
Definition dacryocystitis is an inflammation of the tear sac lacrimal sac at the inner corner of the eye. His group also found the nasal approach more rapid and more acceptable to patients. Those corrections result not only in relief of residual tension around the skull but changes in the entire body. The endonasal dcr technique uses a fiberoptic probe inserted in the punctum for guidance. Jedmed has a full line of instrumentation for the endonasal dcr procedure. Paediatric endonasal endoscopic dcr seems to be an effective, safe and minimally invasive technique for the treat ment of mechanical nasolacrimal system obstruction. Cases of successful endcr 4 patients and exdcr 4 patients were included. Dacryocystectomy definition of dacryocystectomy by. All instruments are handcrafted using the finest german quality stainless steel. The light from the probe is visualized in the nose through a rigid nasal scope. Looking for online definition of dcr or what dcr stands for. Tears generated by the tear glands in your eyes need to be drained to the nose.
Benign growths, sinonasal polyposis, septal deviations, allergic rhinitis, atrophic rhinitis, are all patients fit to be taken up for surgery, but since the pathology could be causative factor should be eliminated beforesimultaneously or after the. Females have significantly smaller dimensions in the lower nasolacrimal fossa and middle nasolacrimal duct. The introduction of endonasal laser dacryocystorhinostomy enldcr in the early 1990s showed great promise of changing dacryocystorhinostomy. Endoscopic endonasal dacryocystorhinostomy dcr is the best, scar free no scar, lacrimal surgery performed for restoration of tears flow into the nose from the lacrimal sac, when the nasolacrimal duct tear duct has become blocked blocked tear duct tear duct obstruction abnormal tearing or epiphora watery eyes takes place due to obstruction in the. These prerequisites encompass appropriate technical equipment. Endoscopic endonasal dcr plays an established role in revision dcr surgery.
To compare the success and complication rates, duration of surgeries and clinical comfort after endoscopic dacryocystorhinostomy enddcr or external dacryocystorhinostomy extdcr. Pooled results showed that both surgical approaches had similar success rates endoscopic endonasal dcr 82. Endoscopic dacryocystorhinostomy dcr has been the preferred treatment in the management of epiphora and many techniques were described by different. Ct scanningsometimes called cat scanningis a noninvasive, painless medical test that helps physicians diagnose and treat medical conditions. The study involved a prospective nonrandomised interventional case series with short perioperative follow up. To compare success rates of external dacryocystorhinostomy dcr and endoscopic endonasal dcr for acquired. In the case of cicatricial obstruction at the osteotomy site, it is easier to perform endoscopic revision, and the patient is more likely to accept such a revision without visible external cuts. Mechanical endonasal dacryocystorhinostomy with mucosal flaps. Dcr is listed in the worlds largest and most authoritative dictionary database of abbreviations and acronyms the free dictionary.
Current and future possibilities with printed model teeth. This article tries to provide few tips to make dcr easy and stressfree. The plugin will add command line options to nosetests. Endonasal dcr should not be done when malignant tumour is in proximity of nldit is may be cause of obstruction. Endoscopic dacryocystorhinostomy oculoplastic eyelid. Dcr, or dacryocystorhynostomy, is a surgery performed to create a new tear drain between the eye and nose when your current tear drain becomes blocked or obstructed.
Endonasal dacryocystorhinostomy ota american academy of. Article in classic viewepub betaprinter friendlycitation. Laser dcr laser dacryocystorhynostomycreating a new tear drain. During recent years endonasal dcr was developed as an alternative surgical technique. Despite ease and decreased morbidity of endonasal dcr, external dcr is procedure of choice as it is more successful. All patients were operated on by same team of surgeons. Most of patients are females so if in any way a scar can be prevented over face will be a better option 4. Dear reader, enhancing the visualization of medical professionals is a core focal point for us at the medical technology business of zeiss. Primary acquired nasolacrimal duct obstruction is the commonest cause of chronic dacryocystitis presenting with symptoms like epiphora, discharge, irritation and pain. External and endonasal dacryocystorhinostomy exdcr and endcr, respectively affect the tear drainage mechanism. Endoscopic vs external dacryocystorhinostomycomparison. Comparison of endoscopic and external dacryocystorhinostomy for. For bone removal, kerrisons punch and dcr burr was used.
To describe and assess the efficacy of mechanical endonasal dacryocystorhinostomy mendcr. Focusing on the endonasal approach, we compared success rates, clinical outcome, complications and patient satisfaction of endoscopic vs. This study was done to assess the efficacy of powered endoscopic dacryocystorhinostomy dcr with creation of a large bony ostium exposing fundus of the sac and primary mucosal anastomosis. The success rates for endonasal dacryocystorhinostomy. Dcr involves opening up your existing tear sac and connecting it directly into the nose to form a new tear drainage pathway. They found a higher rate of success in the stent surgeries.
Dacryocystorhinostomy dcr consists of creating a lacrimal drainage pathway to the nasal cavity to restore permanent drainage of previously obstructed. The light from the probe is visualized in the nose through a rigid nasa. The study involved prospective interventional case series with short perioperative follow up. To study the outcome of endonasal endoscopic dacryocystorhinostomy dcr with or without mucosal flap preservation, without mitomycin local application, silicon tube. Dacryocystitis definition of dacryocystitis by medical. External dacryocystorhinostomy dcr is the mainstay of treatment for this problem with a reasonable. Also, these patients tend to be of an older age group that are not conscious of a small scar by the side of the eye. Using self retaining speculum one can work bimanually. All planmeca cbct imaging units offer an imaging mode tailored for endodontics. Several ophthalmologists fear performing dcr because of bleeding and unfamiliarity of structure. The basic indication is same in all cases and either route can be used. Endonasal dcr can be performed with the help of rigid endoscopes or under binocular operating microscopes. External in short, both techniques are highly successful. This approach allows the surgeon to deal with nasal adhesions, granulomatous tissue and hypertrophic turbinates at the same time.
Both kerrison punch and drill are widely used in endoscopic dcr with. Conventional dacryocystorhinostomy versus endonasal. Laser transcanalicular endonasal dcr is also becoming popular due to its inherent advantages over endonasal laser delivery systems such as the laser direction being away from the globe and the approach being more familiar to the ophthalmic surgeon. His dacryocystorhinostomy through an endonasal approach evaded popularity. Description tears drain into little openings puncta in the inner corners of the eyelids. The spiway is the first and only access guide for endoscopic endonasal skull base surgery. We strive to help our users across a broad range of medical disciplines see more. This potentially leads to cleaner surgical fields and improved surgical efficiency. External versus endonasal dacryocystorhinostomy in a. Endonasal dcr is far superior than external dcr reason is simple and obvious.
Disadvantages of endonasal dcr include the preferred use of general anesthesia by many surgeons, the high cost of expensive equipment and instrumentation, and the relatively steep learning curve for this procedure. Our experience endonasal dacryocystorhinostomy is considered to be the standard treatment for chronic dacryocystitis, and is simple to perform and is very effective even in patients. This study evaluates the preservation of lacrimal pump function in both procedures. A comparison of external and endoscopic endonasal dacryocystorhinostomy for acquired nasolacrimal duct obstruction r karim, r ghabrial, tf lynch, b tangschool of public health, faculty of medicine, university of sydney, sydney, australiapurpose. Endonasal endoscopic dcr with full sac exposure is now considered the. From there, the tears travel through little tubelike structures canaliculi to the lacrimal sac. Using an endoscope, the dcr can be performed by endonasal route using either laser 4,5 or surgical instruments 6,7 or both. Depending on the preference of the surgeon, more postoperative care may be required for patients undergoing endonasal dcr than. This can be accessed though control panel administrative tools services. The spiway is designed to help reduce mucosal trauma and keep the scope clean. You may also be prescribed antibiotic tablets or capsules.
Instructions following endonasal dcr surgery other medications pg2 eye drops, if prescribed, are instilled into the eye 3 times a day. Appropriate frame conditions provided, the respective procedures are safe and successful. Nasal sprays may also be prescribed, and instructions about their use will be provided. There is excellent illumination and magnification 2. Compared with external dcr, endoscopic dcr is more. Twenty two patients were followed up in groupi and thirtysix patients were followed up in groupii. In recent years, threedimensional 3d printing has been mentioned throughout the media as a huge opportunity for industrial manufacturing and.
Mri evaluation of lacrimal drainage after external and. Efficacy of endo nasal dcr in primary nasolacrimal duct. Operative and postoperative data were prospectively. Endoscopic versus external approach dacryocystorhinostomy. Dacryocystorhinostomy dcr is performed in patients with saccal or postsaccal lacrimal duct obstruction.
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