Başarısız endoskopik dakriyosistorinostominin gözden geçirilmesi

Amaç: Bu çalışmada revizyon cerrahisi yapılan hastalarda dakriyosistorinostominin başarısız olmasının nedenleri araştırıldı.Hastalar ve Yöntemler: Ocak 2010 - Ocak 2016 tarihleri arasında revizyon endoskopik dakriyosistorinostomi yapılan toplam 48 hasta 31 kadın, 17 erkek; ort. yaş 39.8±14.2 yıl; dağılım 23-55 yıl geriye dönük olarak incelendi. Revizyon cerrahisinin nedenleri, hastaların ilk ameliyatlarında uygulanan dakriyosistorinostomi yöntemleri ve ilk ameliyatlarında saptanan ek patolojileri kaydedildi.Bulgular: Başarısız olan endoskopik dakriyosistorinostomi ameliyatların çok az farkla guj-çekiç ile yapılanlar olduğu p>0.05 ve arasında en sık revizyon nedeninin yeterli açılmamış kemik pencere olduğu saptandı p0.05 .Sonuç: Çalışma sonuçlarımız endoskopik dakriyosistorinostomide kemik pencere açılmasında kullanılan aletten daha çok, yeterli genişlikte açılmış kemik pencerenin önemli olduğunu göstermektedir. Ayrıca başarı oranını düşürebileceği için, septoplastinin endoskopik dakriyosistorinostomi ile aynı seansta uygulanmamasını öneririz

Revisiting unsuccessful endoscopic dacryocystorhinostomy

Objectives: This study aims to investigate the reasons for failed dacryocystorhinostomy in patients who underwent revision surgery. Patients and Methods: A total of 48 patients 31 females, 17 males; mean age 39.8±14.2 year; range 23 to 55 years who underwent revision endoscopic dacryocystorhinostomy between January 2010 and January 2016 were retrospectively analyzed. The reasons for revision surgery, dacryocystorhinostomy methods in the initial operations, and additional pathologies in the initial operations were recorded. Results: We found that failed endoscopic dacryocystorhinostomy operations were those with chisel-hammer with a slight difference p>0.05 and the most common reason for revision was inadequate bone window opening p0.05 . Conclusion: Our study results that adequate bone window opening is more important than the instrument which is used for opening bone window in endoscopic dacryocystorhinostomy. In addition, we suggest that septoplasty should not be applied in the same session with endoscopic dacryocystorhinostomy, as it can reduce the success rate.

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  • Walker RA, Al-Ghoul A, Conlon MR. Comparison endonasal dacryocystorhinostomy with external dacryocystorhinostomy. Can J Ophthalmol 2011;46:191-5. nonlaser nonendoscopic
  • Herzallah I, Alzuraiqi B, Bawazeer N, Marglani O, Alherabi A, Mohamed SK, et al. Endoscopic Dacryocystorhinostomy (DCR): a comparative study between powered and non-powered technique. J Otolaryngol Head Neck Surg 2015;44:56.
  • Cokkeser Y, Evereklioglu C, Tercan M, Hepsen IF. Hammer-chisel technique in endoscopic dacryocystorhinostomy. Ann Otol Rhinol Laryngol 2003;112:444-9.
  • Çukurova I, Caner Mercan G, Çetinkaya E, Gümüsssoy M, Söken H. Endoscopic dacryocystorhinostomy: outcomes using mucosal flap preserving technique. Eur Arch Otorhinolaryngol 2013;270:1661-6.
  • Park J, Kim H. Office-based endoscopic revision using a microdebrider for failed endoscopic dacryocystorhinostomy. Eur Arch Otorhinolaryngol 2016;273:4329-34.
  • Singh AP, Narula V, Meher R. A new approach to endoscopic DCR. Braz J Otorhinolaryngol 2012;78:7-11.
  • Ali MJ, Singh M, Chisty N, Kamal S, Naik MN. Endoscopic ultrasonic dacryocystorhinostomy: clinical profile and outcomes. Eur Arch Otorhinolaryngol. 2016;273:1789-93.
  • Narioka J, Ohashi Y. Transcanalicular-endonasal semiconductor diode laser-assisted revision surgery for failed external dacryocystorhinostomy. Am J Ophthalmol 2008;146:60-8.
  • Neyt P, Delsupehe L. Powered endonasal dacryocystorhinostomy: technique and results of a series of patients. Bull Soc Belge Ophtalmol 2011;317:33-8.
  • Salami A, Dellepiane M, Salzano FA, Mora R. Piezosurgery in endoscopic dacryocystorhinostomy. Otolaryngol Head Neck Surg 2009;140:264-6. 11. Tsirbas A, Wormald PJ. Endonasal dacryocystorhinostomy with mucosal flaps. Am J Ophthalmol 2003;135:76-83.
  • Welham RA, Henderson PH. Results of dacryocystorhinostomy analysis of causes for failure. Trans Ophthalmol Soc U K 1973;93:601-9.
  • Yung MW, Hardman-Lea S. Analysis of the results of surgical endoscopic dacryocystorhinostomy: effect of the level of obstruction. Br J Ophthalmol 2002;86:792-4.
  • El-Sayed Al-Mosallamy SM. A novel technique to improve the results of conventional dacryocystorhinostomy. J Egypt Ophthalmol Soc 2013;106:230-4.