Rubber tube versus silicone tube at the osteotomy site in dacryocystorhinostomy

To compare the efficacy of using rubber versus silicone tubes at the osteotomy of Dacryocystorhinostomy. 46 patients diagnosed with primary acquired nasolacrimal duct obstruction were assigned randomly to rubber, silicone or control group. The surgical procedures in the three groups were the same except that in patients of rubber and silicone groups, rubber or silicone tubes were placed at osteotomy opening and removed after 3 months. Transnasal endoscopic findings were recorded at the completion of surgery and at 3 months, 6 months and 9 monthes after surgery for the 3 groups. A computer aided digitizer was used to calculate the surface area of the osteotomy site. After removal of their tubes 3 patients in the rubber group had recurrent epiphora [78.0% success], one patient in silicone group [92.86% success] and 4 patients in control group [77.8% success]. The average final surface area of the osteotomy opening of patients with rubber group at the end of follow up was [9.85 mm2] in the silicone group was [17.47mm2] whereas in the control group was [8.56mm2]. Silicone tube more better than rubber one in maintaining effective larger osteotomy after Dacryocystorhinostomy. This can improve the long term success of the operation

Nasolacrimal duct probing: failure and treatment

Purpose: When probing treatment for congenital nasolacrimal duct obstruction falls, it is often unclear whether it is due to technical difficulties, or the severity of obstruction. So, our aim is to study the causes of probing failure and how to treat them

Method: In a prospective study, 36 nasolacrimal ducts of 26 children aged 12 months to 4 years with congenital nasolacrimal duct obstruction [CNLDO] were treated by probing. In all children probing was done under direct vision using nasal endoscopy. Different forms of CNLDO were treated and studied to determine the potential predictors for treatment failure

Results: The overall success rate was 95.5 %. Expected faiure was attributed mainly to the construction of different forms of membranous penetration on probing. Surgical membranotomy at the area of Hasner's valve under direct nasal endoscopic visualization is an essential step for proper management of CNLDO

Middle ear functional changes associated with bilateral anterior nasal packing

Objective: the purpose of this study was to investigate the middle ear functional changes that associate with bilateral anterior nasal packing

Study Design: prospective study group consisted of thirty-eight consenting patients with bilateral anterior nasal packs, twenty males and eighteen females. Their age ranged from 18 to 50 years. The tymapanometric results of 76 ears that underwent bilateral anterior nasal packing after endoscopic nasal operations for chronic sinusitis were measured. The measurement was done before, during, and after nasal packing

Results: type A tympanogram was observed in 31 ears [40%] during bilateral anterior nasal packing and 59 ears [77%] after removal of the pack. While 34 ears [44 %] had type C tympanogram during bilateral anterior nasal packing and only 12 ears [15 %I had type C tympanogram after removal of the pack. Discussion: In this study, there was significant statistical difference between both middle ear functions before and after removal of the bilateral anterior nasal packing. However, there was no significant statistical dr8erence between the right and left ears affliction during the packing or after its removal by one week

Conclusions: this study revealed that there was a high incidence of Eustachian tube dysfunctions in patients with bilateral anterior nasal packs. However, with removal of the pack the middle ear pressure improves towards the pre-nasal pack condition with restoration of the middle ear physiological function after its removal