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1.
Rev. bras. oftalmol ; 80(2): 133-135, Mar.-Apr. 2021. tab
Article in English | LILACS | ID: biblio-1280114

ABSTRACT

ABSTRACT Objetive: To evaluate the success rate of initial and repeated probing as treatment approach for congenital nasolacrimal duct obstruction (CNLDO) in children between 2 and 46 months. Methods: A restrospective review of 73 children diagnosed with CNLDO who underwent probing of the NLD from March 2010 to 2020 was conducted. Data were colected from Hospital Oftalmológico de Anápolis in Anápolis, Goiás. Results: The procedure was performed in 90 eyes. The study sample was constituted of 36 males and 37 females. Bilateral involvement occurred in 18 (24.6%) children whereas 55 (75.3%) of them were unilaterally affected. The age ranges of the patients were divided into 4 groups: A - up to 6 months old (5.5% of the eyes), B - 7 to 12 months (27.5%), group C - 13 to 24 months (39.5%) and group D - older than 24 months (26.4%). The mean age of the sample was 18.6 months. Initial probing obtained an overall success rate of 88.8% and group B showed the best percentage (96%) from all age ranges. The second intervention had a lower outcome, successfuly in 55.5% of the cases. Conclusion: All age ranges showed high success rates for initial probing, although there was a decrease in subsequent procedures outcomes. Our results demonstrate that the success rate for primary probing is not affected by age.


RESUMO Objetivo: avaliar a taxa de sucesso de sondagem inicial e de repetição como abordagem de tratamento para obstrução congênita do ducto nasolacrimal em crianças entre 2 e 46 meses. Métodos: conduziu-se uma revisão retrospectiva de 73 crianças diagnosticadas com obstrução congênita do ducto nasolacrimal que se submeteram à sondagem do ducto nasolacrimal de março de 2010 a 2020. Os dados foram coletados no Hospital Oftalmológico de Anápolis em Anápolis, Goiás. Resultados: o procedimento foi realizado em 90 olhos. A amostra do estudo constitui-se em 36 pacientes do sexo masculino e 37 do sexo feminino. O acometimento foi bilateral em 18 crianças, enquanto 55 (75,3%) delas foram afetadas de forma unilateral. Os pacientes foram divididos em 4 grupos, de acordo com a faixa etária: A- até 6 meses de vida (5,5% dos olhos); B- 7 a 12 meses (27,5%); grupo C- 13 a 24 meses (39,5%) e grupo D- mais que 24 meses (26,4). A média de idade de amostra foi de 18,6 meses. A sondagem inicial teve uma taxa de sucesso global de 88,8%, e o grupo B mostrou a melhor porcentagem (96%) de todas as faixas etárias. A segunda intervenção teve uma taxa de sucesso menor, de 55,5% dos casos. Conclusão: todas as faixas etárias mostraram altas taxas de sucesso na sondagem, embora tenha havido um decréscimo nos resultados dos procedimentos subsequentes. Nossos resultados demonstram que a taxa de sucesso na sondagem primária não é afetada pela idade


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Lacrimal Duct Obstruction/congenital , Lacrimal Duct Obstruction/therapy , Medical Records , Retrospective Studies , Intubation/methods , Therapeutic Irrigation , Nasolacrimal Duct/abnormalities
2.
Arq. bras. oftalmol ; 84(1): 91-98, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1153095

ABSTRACT

ABSTRACT Purpose: Lacrimal probing is the treatment of choice for congenital nasolacrimal duct obstruction that does not have a spontaneous resolution; however, there is no consensus about the best time for probing and if it is superior to other therapies. The present study aimed to evaluate the effectiveness of lacrimal probing compared with other treatments/no intervention to treat congenital nasolacrimal duct obstruction. Methods: A systematic review of literature in PubMed, EMBASE, CENTRAL, clinicaltrials.gov, and LILACS databases up to December 2019 was performed. Randomized clinical trials that enrolled children diagnosed with congenital nasolacrimal duct obstruction and undergoing lacrimal probing were considered. Data extraction and a risk of bias assessment were conducted independently and in duplicate. The overall quality of evidence for each outcome was conducted using the Grading of Recommendations, Assessment, Development, and Evaluation classification system. Results: Four randomized clinical trials involving 423 participants were eligible. No statistically significant differences were observed in resolution rates between early probing and observation/late probing (two studies; risk ratio 1.00 [95% confidence interval 0.76-1.33]; p=0.99; low certainty evidence). One study reported better resolution rates with bicanalicular silicone stent intubation compared with late probing in the complex congenital nasolacrimal duct obstruction cases subgroup (risk ratio 0.56 [95% confidence interval 0.34-0.92]; p=0.02; moderate certainty evidence). Conclusions: Low certainty evidence suggests that early probing has the same success rate as late probing. Evidence of moderate certainty suggests that late probing has a lower success rate than bicanalicular silastic intubation in patients with complex congenital nasolacrimal duct obstructione.


RESUMO Objetivo: A sondagem lacrimal tem sido o tratamento de escolha para a obstrução lacrimonasal congênita que não apresenta resolução espontânea. Contudo, não há consenso sobre qual é a melhor época para a realização da sondagem e se ela é melhor do que outras terapias. O objetivo foi avaliar a efetividade da sondagem lacrimal no tratamento da obstrução lacrimonasal congênita. Método: Uma revisão sistemática da literatura foi realizada usando as plataformas eletrônicas PubMed, EMBASE, CENTRAL, clinicaltrials.gov e LILACS até o período de dezembro de 2019. Foram considerados ensaios clínicos randomizados envolvendo crianças com obstrução lacrimonasal congênita submetidas a sondagem lacrimal. A extração dos dados e avaliação do risco de viés foram feitas por dois autores independentemente. A análise da qualidade da evidência para cada desfecho foi realizada por meio do sistema GRADE (Grading of Recommendations Assessment, Development and Evaluation). Resultados: Quatro ensaios clínicos randomizados foram incluídos, envolvendo 423 participantes. A metanálise mostrou que não houve diferença estatística na resolução da obstrução lacrimonasal congênita entre o grupo submetido à sondagem lacrimal precoce e o submetido à observação/sondagem tardia (2 estudos; risco médio 1.00 [intervalo de confiança de 95% 0.76, 1.33] p=0,99, I2=79%, baixa certeza de evidência). Um estudo evidenciou melhores resultados da intubação bicanalicular com silicone em comparação a sondagem tardia no subgrupo das obstruções lacrimonasais congênitas complexas, (1 estudo; risco médio 0.56 [intervalo de confiança de 95% 0.34, 0.92] p=0,02, moderada certeza de evidência). Conclusões: Há evidências de baixa qualidade de que a sondagem precoce tem a mesma taxa de sucesso que a sondagem tardia. Evidências de moderada certeza sugerem que a sondagem tardia tem menor chance de sucesso do que a intubação bicanalicular com silicone em casos de obstruções lacrimonasais congênitas complexas.


Subject(s)
Humans , Infant , Child , Dacryocystorhinostomy , Lacrimal Duct Obstruction , Nasolacrimal Duct , Randomized Controlled Trials as Topic , Retrospective Studies , Treatment Outcome , Intubation , Lacrimal Duct Obstruction/therapy
3.
Medicentro (Villa Clara) ; 24(3): 564-577, jul.-set. 2020. tab
Article in Spanish | LILACS | ID: biblio-1125016

ABSTRACT

RESUMEN Introducción: la dacriocistorrinostomía externa es la técnica más empleada por la mayoría de los cirujanos oculoplásticos para tratar a los pacientes con obstrucción del canal nasolagrimal. Es posible que los galenos cometan algunos errores en este tipo de cirugía, a pesar de los grandes avances en las tecnologías ópticas, las técnicas quirúrgicas y el uso de modernos materiales de intubación. La principal causa de los errores es el cierre de la osteotomía por tejido cicatrizal o de granulación, con la formación de sinequias en la cavidad nasal. La mitomicina C es el antibiótico alquilante más estudiado en la prevención del exceso de cicatrización en el área de la osteotomía; sin embargo, existen acuerdos y desacuerdos entre estudiosos del tema sobre la eficacia, dosis y tiempo de exposición de este medicamento. El papel de cada una de estas variables en el resultado final de la cirugía es controversial. Objetivo: brindar evidencias sobre el papel de la aplicación transoperatoria de la mitomicina C en la dacriocistorrinostomía externa. Métodos: se realizó una revisión de la bibliografía actualizada disponible en idioma español e inglés. Se consultaron los textos completos y resúmenes en las bases de datos: PubMed, Ebsco, Google Académico y Scielo. También se revisaron novedosos artículos en prestigiosas revistas especializadas. Conclusiones: la mayoría de los autores coinciden en que este medicamento contribuye a elevar la tasa de éxito de la dacriocistorrinostomía externa; aunque su aplicación es segura, todavía se estudian algunas variables que mejorarían su eficacia.


ABSTRACT Introduction: external dacryocystorhinostomy is the most used technique by oculoplastic surgeons to treat patient with nasolacrimal duct obstruction. Physicians may make some mistakes in this type of surgery despite great advances in optical technologies, surgical techniques and the use of modern materials for intubation, The main cause of errors is the closure of the osteotomy due to scar tissue or granulation with synechia formation in the nasal cavity. Mitomycin-C is the most studied alkylating antibiotic in the prevention of excessive scarring in the osteotomy area; however, there are some agreements and disagreements among scholars on the efficacy, dosage and time of exposure of this drug. The role of each of these variables in the final outcome of the surgery is controversial. Objective: to provide some evidences about the transoperative application of Mitomycin-C in external dacryocystorhinostomy. Methods: a review of the updated bibliography available in Spanish and English languages was carried out. Complete texts and abstracts were consulted in the databases: PubMed, Ebsco, Google Scholar and Scielo. Novel articles were also reviewed in prestigious specialized journals. Conclusions: must authors agree that this drug appears to improve the success rate of external dacryocystorhinostomy. Although its application is safe, some variables are still being studied that would improve its efficacy.


Subject(s)
General Surgery , Dacryocystorhinostomy , Mitomycin , Lacrimal Apparatus , Lacrimal Duct Obstruction
4.
Arq. bras. oftalmol ; 83(4): 332-334, July-Aug. 2020. graf
Article in English | LILACS | ID: biblio-1131613

ABSTRACT

ABSTRACT Dacryocystocele is a rare benign facial abnormality of the nasolacrimal system, which may be detected at the antenatal workup during the third trimester of pregnancy. Ultrasound is the method of choice for this examination. However, magnetic resonance imaging may also be used in selected cases. Dacryocystocele is mostly a transient finding; it may resolve spontaneously in utero or postnatally. When the defect is bilateral and persists in neonatal life, it may lead to respiratory complications. We report a case of a fetus with bilateral dacryocystocele diagnosed by prenatal ultrasound at the beginning of the third trimester of pregnancy with spontaneous postpartum resorption.


RESUMO A dacriocistocele é uma anormalidade facial benigna rara do sistema nasolacrimal, que pode ser detectada na rotina pré-natal durante o terceiro trimestre da gravidez. O ultrassom é o método de escolha, mas a ressonância magnética também pode ser usada em casos específicos. Na maioria das vezes, a dacriocistocele é um achado temporário, que pode se resolver espontâneamente ainda no útero ou após o nascimento. Quando a anormalidade é bilateral e persiste na vida neonatal, pode levar a complicações respiratórias. Este é o relato do caso de um feto com dacriocistocele bilateral diagnosticada por ultrassom pré-natal no início do terceiro trimestre da gravidez, com reabsorção espontânea após o nascimento.


Subject(s)
Humans , Female , Cysts , Lacrimal Duct Obstruction , Pregnancy , Magnetic Resonance Imaging , Ultrasonography, Prenatal , Lacrimal Duct Obstruction/diagnostic imaging , Nasolacrimal Duct/diagnostic imaging
5.
Arq. bras. oftalmol ; 83(3): 229-235, May-June 2020. tab
Article in English | LILACS | ID: biblio-1131581

ABSTRACT

ABSTRACT Purpose: Mitomycin C has been used in ophthalmic surgery to mitigate postoperative scarring. However, the outcomes of endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction with adjunctive mitomycin C in children remain unknown. Our study was aimed to evaluate the efficacy and safety of adjunctive application of mitomycin C after endoscopic-assisted probing for the treatment of congenital nasolacrimal duct obstruction in children. Methods: This is a retrospective chart review performed in a tertiary eye care hospital involving children with congenital nasolacrimal duct obstruction, who underwent endoscopic-assisted probing from October 2013 to August 2015. We compared children who underwent endoscopic-assisted probing with mitomycin C (mitomycin C group) versus others who underwent endoscopic-assisted probing without mitomycin C (endoscopic-assisted probing group). The mitomycin C group received 0.2 mg/ml within 4 min to the nasolacrimal duct ostium using a cotton tip applicator immediately after probing. Probing was considered successful when patient complaints of tearing were reduced or the results of the dye disappearance test were normal. Demographic data, clinical features, and intraoperative and postoperative variables were correlated to the success rate. Results: The study sample comprised 68 lacrimal vies. The majority of children had bilateral obstruction and no previous history of probing. The mean age of the patients was approximately 4 years. Most obstructions were considered complex. The success rates were high in both groups (p>0.05). There were no adverse events related to the use of mitomycin C (p>0.05). Conclusions: Although mitomycin C has no adverse effects when applied to the opening of the nasolacrimal duct, its use after lacrimal probing for the treatment of congenital nasolacrimal duct obstruction does not improve the chance of success.


RESUMO Objetivo: A mitomicina C tem sido usada em cirurgia oftálmica para reduzir cicatrizes pós-operatórias. Entretanto, os resultados da sondagem endoscópica assistida para o tratamento da obstrução congênita do ducto nasolacrimal com mitomicina C adjuvante em crianças permanecem desconhecidos. Nosso estudo teve como objetivo avaliar a eficácia e a segurança da aplicação da mitomicina C após a sondagem endoscópica assistida para o tratamento da obstrução congênita do ducto nasolacrimal em crianças. Métodos: Trata-se de uma revisão retrospectiva de prontuários, realizads em um hospital terciário de oftalmologia, envolvendo crianças com obstrução congênita do ducto nasolacrimal, submetidas à sondagem endoscópica de Outubro de 2013 a Agosto de 2015. Comparamos crianças submetidas à sondagem endoscópica com mitomicina C (grupo mitomicina C) versus outros que foram submetidos à sondagem endoscópica sem mitomicina C (grupo de sondagem endoscópica). O grupo mitomicina C recebeu 0,2 mg/ml em 4 min para o óstio do ducto nasolacrimal usando um aplicador de ponta de algodão imediatamente após a sondagem. A sondagem foi considerada bem-sucedida quando as queixas de lacrimejamento dos pacientes foram reduzidas ou os resultados do teste de desaparecimento do corante foram normais. Dados demográficos, sinais clínicos, variáveis intra e pós-operatórias foram correlacionados com a taxa de sucesso. Resultados: A amostra do estudo foi composta por 68 vias lacrimais. A maioria das crianças apresentava obstrução bilateral e sem histórico prévio de sondagem. A média de idade dos pacientes era de aproximadamente 4 anos. A maioria das obstruções foi considerada complexa. As taxas de sucesso foram altas nos dois grupos (p>0.05). Não houve efeitos adversos relacionados ao uso da mitomicina C (p>0.05). Conclusões: Apesar a mitomicina C não tenha efeitos adversos quando aplicada à abertura do ducto nasolacrimal, seu uso após sondagem lacrimal no tratamento da obstrução congênita do ducto nasolacrimal não melhora a chance de sucesso.


Subject(s)
Humans , Child, Preschool , Dacryocystorhinostomy , Lacrimal Duct Obstruction , Nasolacrimal Duct , Retrospective Studies , Mitomycin
6.
Arq. bras. oftalmol ; 83(1): 1-4, Jan.-Feb. 2020. tab
Article in English | LILACS | ID: biblio-1088953

ABSTRACT

ABSTRACT Purpose: To determine the reliability of the endoscopic dye transit test for the prediction of functional success after dacryocystorhinostomy. Methods: A cross-sectional study was conducted with 50 patients who underwent external dacryocystorhinostomy Group or transcanalicular dacryocystorhinostomy Group and had anatomically patent ducts during irrigation, with a minimum 6-month follow-up. The external dacryocystorhinostomy, defined as the time from instillation of the dye into the conjunctival sac until its flow from the rhinostomy site, was performed in all patients. Positive predictive value of the endoscopic dye transit test to assess functional success was analyzed. The cutoff point was determined using a receiver operating characteristic curve. Results: Of the 50 patients, 44 (88%) exhibited subjective improvement or complete resolution of epiphora (functional success). The best cutoff point for the endoscopic dye transit test was 60 s. Of 39 patients with endoscopic dye transit test £60 s, 38 (97.4%) exhibited functional success, demonstrating a 97.4% positive predictive value. Conclusion: The endoscopic dye transit test £60 s is a reliable tool to predict functional success and good prognosis after external or laser transcanalicular dacryocystorhinostomy.


RESUMO Objetivo: Determinar a confiabilidade do teste endoscópico do corante na predição do sucesso funcional após dacriocistorrinostomia. Métodos: Estudo transversal com 50 pacientes submetidos ao grupo de dacriocistorrinostomia externa ou grupo dacriocistorrinostomia transcanalicular e que possuíam dutos anatomicamente patentes pela irrigação, com seguimento mínimo de 6 meses. A dacriocistorrinostomia externa, definida como o tempo desde a instilação do corante no saco conjuntival até o fluxo do local da rinostomia, foi realizada em todos os pacientes. O valor preditivo positivo do teste endoscópico do corante para avaliar o sucesso funcional foi analisado. O ponto de corte foi determinado usando uma curva característica de operação do receptor. Resultados: Dos 50 pacientes, 44 (88%) apresentaram melhora subjetiva ou resolução completa da epífora (sucesso funcional). O melhor ponto de corte para o teste endoscópico do corante foi de 60 s. Dos 39 pacientes com teste endoscópico do corante £60 s, 38 (97,4%) apresentaram sucesso funcional, demonstrando um valor preditivo positivo de 97,4%. Conclusão: O teste en­doscópico do corante £60 s é uma ferramenta confiável para predizer o sucesso funcional e o bom prognóstico após dacriocistorrinostomia transcanalicular externa ou a laser.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Dacryocystorhinostomy/methods , Lasers, Semiconductor/therapeutic use , Lacrimal Duct Obstruction/diagnosis , Nasolacrimal Duct/physiopathology , Cross-Sectional Studies , Predictive Value of Tests , Reproducibility of Results , Contrast Media , Endoscopy/methods
7.
Rev. bras. oftalmol ; 79(1): 33-37, Jan.-Feb. 2020. tab, graf
Article in Portuguese | LILACS | ID: biblio-1092652

ABSTRACT

Resumo Objetivo: Avaliar e comparar a taxa de sucesso da intubação monocanalicular ou bicanalicular em pacientes com obstrução congênita do ducto lacrimonasal (OCDLN), levando-se em consideração a taxa de sucesso, a dificuldade do procedimento e o custo dos tubos. Métodos: Foram analisados retrospectivamente 54 prontuários, totalizando 58 vias lacrimais com diagnóstico de OCDLN, que realizaram intubação das vias lacrimais monocanalicular ou bicanalicular com tubos de silicone. Anamnese, exame oftalmológico geral, testes específicos, como o Teste do Desaparecimento do Corante (TDC) e Teste de Observação de Fluoresceína na Orofaringe (TOFO), e, caso necessário, exames complementares como a dacriocistografia, foram utilizados para diagnóstico e inclusão na pesquisa. Foram tratados com intubação os pacientes sem resposta adequada ao tratamento prévio, ou seja, que permaneceram com sintomas de secreção e epífora contínua após a realização de massagem de Crigler e sondagem. Resultados: A intubação monocanalicular foi realizada em 27 vias lacrimais e a intubação bicanalicular, em 31 vias lacrimais. A taxa de sucesso foi alta em ambos os métodos, com melhora em 26 (96,3%) vias lacrimais com sonda monocanalicular e em 30 (96,8%), com sonda bicanalicular (p=0,718). As duas técnicas apresentaram 100% de sucesso nos pacientes com até 2 anos e acima de 4 anos de idade (p=1). A taxa de sucesso entre os 2 e 4 anos de idade foi de 91,5% para as monocanaliculares e 87,5% para as bicanaliculares, (p=0,652). Conclusão: o presente estudo não mostrou diferença significativa no sucesso da intubação quando utilizando sondas mono ou bicanaliculares. A intubação monocanalicular mostrou-se de mais fácil execução, ao passo que o tubo bicanalicular possui menor custo.


Abstract Objective: to evaluate and to compare the success rate of monocanalicular or bicanalicular intubation in congenital nasolacrimal duct obstruction (CNDO) carriers in terms of success rate, difficulty of the procedure, and cost of the tubes. Methods: fifty-four CNDO carriers with 58 obstructed lacrimal vies (LV) who were submitted to lacrimal system intubation using mono or bicanalicular stent had their medical records analyzed. A clinical history, a general ophthalmologic examination, specific tests such as the fluorescein dye disappearance test (FDDT) and observation test of fluorescein in the oropharynx (OTFO) were used for diagnosis and inclusion in the study. Patients who continued exhibiting discharge and continuous epiphora after previous treatment, Crigler massage and probing, were treated surgically with intubation. Results: Monocanalicular intubation was performed on 27 LV and bicanalicular intubation was performed on 31 LV. High success rates were observed, with improvement in 26 (96.3%) with monocanalicular intubation and in 30 LV (96.8%) with bicanalicular intubation (p=0.718). Furthermore, both techniques were 100% successful in patients up to 2 and over 4 years of age (p=1). The success rates between 2-4 years of age were 91.6% in monocanalicular intubation and 87.5% in bicanalicular intubation (p=0.652). Conclusion: The success rate using monocanalicular or bicanalicular intubation to treat CNDO had no significant difference in the studied children. Furthermore, the monocanalicular tube was easier to use, while the bicanalicular tube had a lower cost.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Stents , Intubation/instrumentation , Intubation/methods , Lacrimal Duct Obstruction/therapy , Nasolacrimal Duct/abnormalities , Silicones , Comparative Study , Medical Records , Retrospective Studies , Conservative Treatment , Lacrimal Duct Obstruction/congenital , Nasolacrimal Duct/surgery
8.
Article in English | AIM, AIM | ID: biblio-1266540

ABSTRACT

Context:Lacrimal drainage system obstruction gives discomfort to patients and threatens intraocular surgeries by infection, thus, knowledge of its bacteriology leads to the choice of effective therapy.Aim:To determine the bacteriology of nasolacrimal duct obstruction in an adult Libyan patient population and to analyze the appropriate antimicrobial therapy based on susceptibility testing.Settings and Design:A prospective study was conducted at the Great River Eye hospital, Benghazi/Libya in the period between September 2005 and February 2007.Methods:Lacrimal swab materials collected from patients aged 1862 years who were diagnosed as having lacrimal passage obstruction and referred for lacrimal drainage surgery. The specimens were cultured and results analyzed.Results:Of 86 cases, 87.2% yielded a positive culture result. The majority of microorganisms were gram positive bacteria (73.3%) with Staphylococcus Aureus being the most frequently cultured species (36%) of the sample. Gram negative bacteria represented 26.7% of the isolates. The most common gram negative bacteria were Pseudomonas, Klebsiella, and E. coli which were isolated in 8% of the cases each. Staphylococcus aureus was isolated from 28.6% of cases having epiphora with no clinical signs of lacrimal drainage system infection. Ciprofloxacin (96%) and Gentamycin (94.7%) were found to be the most sensitive antibiotics against isolated organisms.Conclusions:Adult patients with lacrimal drainage system obstruction harbor microorganisms in their lacrimal sacs indicating the importance of investigating patients before planning for intraocular surgeries and considering prophylactic use of antibiotics before lacrimal drainage procedures


Subject(s)
Drainage , Lacrimal Duct Obstruction/microbiology , Libya , Microbial Sensitivity Tests
9.
Chinese Medical Journal ; (24): 2422-2428, 2020.
Article in English | WPRIM | ID: wpr-877858

ABSTRACT

BACKGROUND@#Hasner valve incision has been recently introduced as a new treatment for ophthalmic patients with epiphora symptoms. The aim of this study was to examine whether surgical outcomes of Hasner valve incision for inferior nasolacrimal duct obstruction were different between pediatric and adult patients.@*METHODS@#A total of 53 eyes of 52 patients who underwent Hasner valve incision in the Beijing Tongren Hospital from October 2016 to November 2019 were retrospectively observed. Patients were divided into two groups, including pediatric group (23 eyes of 22 patients,  0.05).@*CONCLUSION@#Hasner valve incision was effective for both adult and children with inferior nasolacrimal duct obstruction, with no difference in surgical outcomes between the two groups.


Subject(s)
Adolescent , Adult , Child , Dacryocystorhinostomy , Humans , Lacrimal Duct Obstruction , Nasolacrimal Duct , Retrospective Studies , Treatment Outcome
11.
Rev. cuba. oftalmol ; 32(4): e806, oct.-dic. 2019. graf
Article in Spanish | LILACS, CUMED | ID: biblio-1099105

ABSTRACT

RESUMEN Los tumores del saco lagrimal son extremadamente raros, y el benigno primario más común es el papiloma escamoso. Clínicamente se manifiestan como una zona de tumefacción en la región cantal medial, asociado a epifora y dacriocistitis crónica-recurrente. Dentro de las pruebas de imagen recomendadas están: dacriocistografía, tomografía computarizada, resonancia magnética y dacrioescintifotografía. Sin embargo, muy pocos sugieren el uso del ultrasonido. Se presenta el caso de un papiloma mixto del saco lagrimal diagnosticado por ultrasonido. Se trata de una paciente femenina de 39 años, quien fue remitida por cuadros repetidos de dacriocistitis derecha en los últimos 3 años. En consulta se constató celulitis preseptal ipsolateral, por lo que se indicó antibiótico-terapia, y se logró la remisión de los signos inflamatorios agudos, pero persistió el aumento del volumen cantal medial derecho. La vía lagrimal se exploró y se comprobó que estaba obstruida. Se realizó ultrasonido, donde el saco lagrimal derecho apareció ocupado por una masa ecogénica, que se extendía al conducto lacrimonasal y mostraba ligera vascularidad. Seguidamente se hizo tomografía computarizada, y se confirmaron los hallazgos ecográficos, pero sin lograr delimitar la lesión intrasaco descrita, aún tras la administración de contraste yodado endovenoso. Se sugirió dacriocistitis crónica derecha, secundaria al tumor intrasaco de aspecto benigno, probable papiloma, por lo que se efectuó cirugía y examen histopatológico que ratificaron dicho diagnóstico. En conclusión, el ultrasonido del saco lagrimal es un método complementario de gran valor, que en algunos casos hará el diagnóstico, y en otros brindará información que optimizará la decisión de quienes serían tributarios a estudios más complejos(AU)


ABSTRACT Lacrimal sac tumors are extremely rare, and the most common benign primary is squamous papilloma. Clinically, they manifest as a zone of swelling in the medial canthal region, associated with epiphora and chronic-recurrent dacryocystitis. Among the recommended imaging tests are dacryostography, computed tomography, magnetic resonance imaging, and dacryoscintifotography. However, very few suggest the use of ultrasound. The case of a mixed papilloma of the lacrimal sac diagnosed by ultrasound is presented. This is a 39-year-old female patient, who was referred for repeated cases of right dacryocystitis in the last three years. In consultation, ipsolateral preseptal cellulitis was found, for which antibiotic therapy was indicated, and the remission of acute inflammatory signs was achieved, but the increase in right medial canthal volume persisted. The lacrimal duct was explored and found to be obstructed. Ultrasound was performed, where the right lacrimal sac appeared occupied by an echogenic mass, which extended to the lacrimal duct and showed slight vascularity. Subsequently, computed tomography was performed, and the ultrasound findings were confirmed, but without defining the described intrasaccal lesion, even after administration of intravenous iodinated contrast. It was suggested chronic right dacryocystitis, secondary to apparently benign intrasaccal tumor, probable papilloma, so surgery and histopathological examination were performed, which that ratified the diagnosis. In conclusion, ultrasound of the lacrimal sac is a complementary method of great value, which in some cases will make the diagnosis, while in others it will provide information that will optimize the decision of those who would be candidate to more complex studies(AU)


Subject(s)
Humans , Female , Adult , Papilloma/drug therapy , Dacryocystorhinostomy/methods , Dacryocystitis/etiology , Lacrimal Duct Obstruction/diagnostic imaging
12.
Arq. bras. oftalmol ; 82(5): 394-399, Sept.-Oct. 2019. graf
Article in English | LILACS | ID: biblio-1019429

ABSTRACT

ABSTRACT Purpose: Punctal stenosis can result in symptoms such as epiphora and can significantly reduce the quality of life of patients. Perforated punctal plug insertion is an easy procedure that is commonly used as the first step of treatment for punctal stenosis. Methods: Clinical, demographic, and outcome data were retrospectively collected for 54 eyes of 21 males and 11 females who consecutively presented to our Oculoplastic Clinic and underwent silicone Micro Flow perforated punctal plug insertion. All patients had epiphora with punctal stenosis. Results: Of the 54 plugs, 26 plugs (48.1%) were lost and 28 (51.8%) stayed in place. Of the latter, eight were explanted because of the occlusion of the plug with secretions and recurrent conjunctivitis; moreover, two plugs migrated deep into the vertical canaliculus. Of the 54 plugs, only 18 (33.3%) were well-tolerated with significant symptomatic improvement. Conclusion: Plug loss is a prominent problem in patients implanted with perforated punctal plugs. Silicone punctal plugs failed in 66.7% of our patients over a mean follow-up of 14.2 months.


RESUMO Objetivo: A estenose punctal pode resultar em sintomas como a epífora e diminuir significativamente a qua­lidade de vida dos pacientes. A inserção de um tampão perfurado é um procedimento fácil que é comumente usado como o primeiro passo do tratamento para a estenose punctal. Métodos: Dados clínicos, demográficos e de resultado foram coletados retrospectivamente de 54 olhos de 21 homens e 11 mulheres que consecutivamente se apresentaram em nossa Clínica de Oculoplástica e foram submetidos a inserção de um tampão de silicone perfurado Micro Flow. Todos os pacientes tinham epífora com estenose punctal. Resultados: Dos 54 tampões, 26 (48,1%) foram perdidos e 28 (51,8%) permaneceram no local. Destes últimos, 8 foram removidos devido a oclusão do tampão com secreção e conjuntivite recorrente, além disso, 2 migraram profundamente no canalículo vertical. Dos 54 tampões, apenas 18 (33,3%) foram bem tolerados com significativa melhora dos sintomas. Conclusão: A perda de tampões é um problema de destaque em pacientes implantados com tampões perfurados. Tampões de silicone falharam em 66,7% dos pacientes durante um seguimento médio de 14,2 meses.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Silicones/administration & dosage , Dry Eye Syndromes/surgery , Punctal Plugs/adverse effects , Lacrimal Apparatus/surgery , Lacrimal Duct Obstruction/therapy , Prostheses and Implants , Tears , Dry Eye Syndromes/complications , Prosthesis Implantation , Lacrimal Duct Obstruction/etiology
13.
Article in Korean | WPRIM | ID: wpr-766887

ABSTRACT

PURPOSE: To investigate the efficacy and factors affecting the success rates of nasolacrimal probing and silicone intubation (SI) in patients with congenital nasolacrimal duct obstruction (CNLDO). METHODS: We retrospectively reviewed the medical records of patients including 69 eyes of 59 patients who received probing and 61 eyes of 49 patients who received SI. In patients with probing, the age, sex, and history of conservative treatment were analyzed in the success and failure groups, and a success rate comparison was conducted by dividing these values into postnatal group 1 ( 12 months, the success rate of probing was lower than in patients 12 months.


Subject(s)
Humans , Intubation , Lacrimal Duct Obstruction , Logistic Models , Medical Records , Nasolacrimal Duct , Retrospective Studies , Silicon , Silicones
14.
Article in English | WPRIM | ID: wpr-741316

ABSTRACT

PURPOSE: We sought to evaluate the outcomes of external dacryocystorhinostomy (DCR) and mono-canalicular intubation in patients with total obstruction of one canalicus. METHODS: Sixteen eyes of 16 patients with nasolacrimal duct obstruction and a single canaliculus obstruction who had undergone external DCR and monocanalicular intubation of the intact canaliculus were retrospectively included in the present study. The monocanalicular tube (Mini Monoka) was left in place for at least two months. Munk epiphora grading for the evaluation of epiphora and irrigation was performed both preoperatively and at 6 months postoperatively. RESULTS: Mean patient age was 46 ± 14.2 (range, 18 to 76) years. The inferior canaliculus was obstructed in nine eyes (group A) and the superior canaliculus was obstructed in seven eyes (group B), respectively. Eight eyes had chronic dacryocystitis and two of these eyes also had a history of acute dacryocystitis attack. Mean preoperative Munk scores were 3.89 in group A and 4.0 in group B. Ocular surface irritation occurred in one eye in group A. Artificial eye drops were prescribed and early tube removal was not performed. Spontaneous tube dislocation was recorded in one eye in group B. No other corneal, punctal, or canalicular complications were found. At six months, irrigation of intact canaliculus was patent in all eyes. Mucoid discharge, conjunctival hyperemia, and chronic conjunctivitis were also resolved. Postoperative Munk scores were 1.11 ± 0.9 in group A and 0.86 ± 0.9 in group B. Of note, preoperative and postoperative Munk scores were significantly different in both groups (group A, p = 0.006; group B, p = 0.017). The postoperative Munk scores were not statistically different between the two groups (p = 0.606). CONCLUSIONS: In patients with nasolacrimal duct obstruction and a total of one canaliculus obstruction, external DCR and monocanalicular intubation of the intact canaliculus is an effective surgical option.


Subject(s)
Conjunctivitis , Dacryocystitis , Dacryocystorhinostomy , Joint Dislocations , Eye, Artificial , Humans , Hyperemia , Intubation , Lacrimal Apparatus Diseases , Lacrimal Duct Obstruction , Nasolacrimal Duct , Retrospective Studies
15.
Arq. bras. oftalmol ; 81(6): 500-504, Nov.-Dec. 2018. tab
Article in English | LILACS | ID: biblio-973850

ABSTRACT

ABSTRACT Purpose: To report demographic features and surgical outcomes of 320 children undergoing external dacryocystorhinostomy for dacryostenosis. Methods: We performed a retrospective evaluation of the records of patients aged <16 years who underwent external dacryocystorhinostomy. Patient demographic features and success rates of the operations were analyzed from the data records. Children with <12-month follow-up were not enrolled in the study. Results: We identified 326 operative records of 320 children (162 [50.6%] girls and 158 [49.4%] boys) who underwent external dacryocystorhinostomy with a mean follow-up of 26.03 ± 11.11 months. Overall, we evaluated 116 (35.6%) cases of congenital nasolacrimal duct obstruction. Our series demonstrated a 99.4% success rate for external dacryocystorhinostomy. Conclusions: External dacryocystorhinostomy in children has a high success rate if performed by an experienced oculoplastic surgeon.


RESUMO Objetivo: Relatar as características demográficas e os resultados cirúrgicos em 320 crianças submetidas à dacriocistorrinostomia externa para dacrioestenose. Métodos: Foi realizada uma avaliaçãodos prontuários de pacientes com idade <16 anos submetidos à cirurgia de dacriocistorrinostomia externa. Características demográficas do paciente e taxa de sucesso das operações foram analisadas a partir dos registros de dados. Crianças com menos de 12 meses de acompanhamento não foram incluídas no estudo. Resultados: Foram identificados 326 registros operatórios de 320 crianças (162 [50,6%] meninas e 158 [49,4%] meninos) que foram submetidas à dacriocistorrinostomia externa com um seguimento médio de 26,03 ± 11,11 meses. No geral, avaliamos 116 (35,6%) casos de obstrução congênita do ducto nasolacrimal. Nossa série demonstrou uma taxa de sucesso de 99,4% para a dacriocistorrinostomia externa. Conclusão: A dacriocistorrinostomia externa em crianças tem uma alta taxa de sucesso se for realizada por um cirurgião oculoplástico experiente.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Technology Assessment, Biomedical , Dacryocystorhinostomy/statistics & numerical data , Lacrimal Duct Obstruction , Postoperative Period , Silicones/therapeutic use , Dacryocystorhinostomy/methods , Retrospective Studies , Follow-Up Studies , Treatment Outcome , Surgeons
16.
Arq. bras. oftalmol ; 81(6): 490-493, Nov.-Dec. 2018. tab
Article in English | LILACS | ID: biblio-973846

ABSTRACT

ABSTRACT Purpose: To evaluate whether any topical anti-glaucoma medications increase the risk of lacrimal drainage system obstruction or whether the presence of preservatives alone is sufficient to generate obstruction. Methods: This nested case-control study compared a group of patients with lacrimal duct obstruction who received topical anti-glaucoma medications to a control group of patients without obstruction. Results: The medical records of 255 patients with glaucoma who consulted the Oculoplastic Section with complaints of watery eyes were reviewed. Among these patients, 59 exhibited lacrimal drainage obstruction. Ninety-four percent of patients with lacrimal drainage obstruction used beta-blockers, and 41% used prostaglandin analogs. A logistic regression model was used to adjust for age, sex, and the use of other medications. No significant differences were observed regarding the topical anti-glaucoma medications used between groups. Conclusion: No single topical anti-glaucoma medication demonstrated a stronger association with the development of lacrimal duct obstruction.


RESUMO Objetivo: Avaliar se algum medicamento tópico anti-glaucoma aumenta o risco de obstrução do sistema de drenagem lacrimal ou se a presença de conservantes é su fi cien te para gerar obstrução. Métodos: Este estudo de caso-controle aninhado comparou um grupo de pacientes com obstrução do ducto lacrimal que receberam medicações tópicas anti-glaucoma contra um grupo controle de pacientes sem obstrução. Resultados: Foram revistos os prontuários de 255 pacientes com glaucoma que consultaram a Seção de Oculoplástica com queixas de olhos lacrimejantes. Dentre esses pacientes, 59 apresentavam obstrução da via lacrimal de drenagem. Noventa e quatro por cento dos pacientes com obstrução usaram betabloqueadores e 41% usaram análogos de prostaglandinas. Um modelo de regressão logística foi utilizado para ajustar a idade, sexo e o uso de outros medicamentos. Não foram observadas diferenças significativas em relação às medicações tópicas anti-glaucoma usadas entre os grupos. Conclusão: Nenhum medicamento anti-glaucoma tópico único demonstrou uma associação mais forte com o desenvolvimento de obstrução do ducto lacrimal.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Ophthalmic Solutions/therapeutic use , Glaucoma/drug therapy , Lacrimal Duct Obstruction/complications , Preservatives, Pharmaceutical/therapeutic use , Prostaglandins, Synthetic/therapeutic use , Carbonic Anhydrase Inhibitors/therapeutic use , Case-Control Studies , Glaucoma/complications , Retrospective Studies , Adrenergic beta-Antagonists/therapeutic use , Administration, Ophthalmic
17.
Arch. argent. pediatr ; 116(1): 77-80, feb. 2018. tab
Article in Spanish | LILACS, BINACIS | ID: biblio-1038407

ABSTRACT

Introducción. La obstrucción congénita de la vía lagrimal es una patología común, de poca morbilidad, pero no exenta de complicaciones sin el diagnóstico y manejo correcto. Población y métodos. Estudio retrospectivo de 2005 a 2015 en pacientes que fueron sometidos a un procedimiento de sondaje. Se identificó edad al momento del procedimiento, género, lateralidad y presencia o ausencia de éxito con el procedimiento. Resultados. Se analizaron 137 ojos. La mediana de edad fue de 17 meses y la tasa de éxito total fue del 85,4%. Conclusión. La obstrucción congénita de la vía lagrimal con adecuado manejo conservador inicial tiene alta tasa de resolución espontánea y, en pacientes mayores de 12 meses, el sondaje tiene una alta tasa de éxito.


Introduction. The congenital nasolacrimal duct obstruction is a common pathology, with low morbidity, but not exempt of complications without the correct diagnosis and management. Methods. Retrospective study from 2005 to 2015 in patients who were submitted to a probing procedure. We identified age at procedure, gender, laterality and presence or absence of success with the procedure. Results. One hundred thirty-seven eyes were analyzed. The median age was 17 months and the total success rate was 85.4%. Conclusion. In congenital nasolacrimal duct obstruction there is a high rate of spontaneous resolution with the proper initial conservative management and, in patients older than 12 months, probing has a high rate of success.


Subject(s)
Humans , Infant , Child, Preschool , Surgical Procedures, Operative , Lacrimal Apparatus Diseases , Lacrimal Duct Obstruction
18.
Article in English | WPRIM | ID: wpr-719169

ABSTRACT

PURPOSE: To compare the tear film lipid layer thickness (LLT) between patients with incomplete nasolacrimal duct obstruction (NLDO) and normal controls and to analyze the changes in tear film LLT and blinking pattern after silicone tube intubation in NLDO patients. METHODS: We reviewed the medical records of 68 eyes in 52 incomplete NLDO patients who underwent silicone tube intubation from January 2017 to July 2017. The LLT, blinking pattern, and Meibomian gland image were measured with the LipiView II ocular surface interferometer. The Meibomian gland drop-out ratio was measured using the polygon selection tool in the Image J program. Tear meniscus height, which is the other lacrimal indicator, was assessed with spectral-domain optical coherence tomography. RESULTS: Tear meniscus height was significantly decreased after silicone tube intubation (p < 0.01). Preoperative minimum, maximum, and average LLT values were 62.4 ± 24.0, 86.7 ± 17.9, and 71.7 ± 23.3 nm, respectively. Significant changes in the minimum, maximum, and average LLT (74.8 ± 23.6, 98.8 ± 11.0, and 91.6 ± 16.1 nm, respectively) were observed after silicone tube intubation (p < 0.001, p = 0.001, and p < 0.001). The partial blinking/total blinking ratio in 20 seconds and the Meibomian gland drop-out ratio showed no significant change after silicone tube intubation. CONCLUSIONS: Overall, the LLT was increased after silicone tube intubation. Silicone tube intubation may be helpful in maintaining LLT with a normalized of amount of tears.


Subject(s)
Blinking , Humans , Intubation , Lacrimal Duct Obstruction , Medical Records , Meibomian Glands , Nasolacrimal Duct , Silicon , Silicones , Tears , Tomography, Optical Coherence
19.
Arq. bras. oftalmol ; 80(5): 296-299, Sept.-Oct. 2017. tab
Article in English | LILACS | ID: biblio-888141

ABSTRACT

ABSTRACT Purpose: To estimate the prevalence of external punctal stenosis (EPS) in the elderly population and investigate associated factors. Methods: A total of 278 patients ≥65 years of age were evaluated for evidence of EPS from January to July 2016. Associated systemic, ocular, demographic, and lifestyle factors were investigated. Multiple logistic regression analyses were applied to evaluate the factors related to having EPS. P values <0.05 were considered statistically significant. Results: The prevalence of EPS in this study population was 63.3%, with a mean age of 70.67 ± 7.85 (65-92 years). The ocular factor that was most commonly related to EPS was chronic blepharitis (48.9%). EPS was also associated with taking glaucoma medications (95% CI, 0.08-0.96, p=0.043), smoking history (95% CI, 0.13-0.84, p=0.021), ectropion (95% CI, 0.004-0.26, p=0.001), complaints of tearing (95% CI, 1.11-3.52, p=0.02), and outdoor occupational activity (95% CI, 3.42-9.97, p<0.05). Conclusions: EPS is more common in elderly patients than in the general population. Outdoor occupational activity, taking antiglaucomatous medications, ectropion, and smoking are significantly associated with EPS. In addition, surgical treatment decisions should be made after complete evaluation and interviewing the patients.


RESUMO Objetivo: Estimar a prevalência de estenose externa do ponto lacrimal (EEPL) na população idosa e investigar os fatores associados. Métodos: Foram avaliados 278 pacientes ≥65 anos com estenose externa do ponto lacrimal de janeiro a julho de 2016. Todos os fatores sistêmicos, oculares, demográficos e de estilo de vida associados foram investigados. Foram utilizadas análises de regressão logística múltipla para avaliar os fatores relacionados a estenose externa do ponto lacrimal, valores de p<0,05 foram considerados estatisticamente significativos. Resultados: A prevalência de estenose externa do ponto lacrimal foi de 63,3%, com idade média de 70,67 ± 7,85 (65-92 anos). O fator ocular mais relacionado com estenose externa do ponto lacrimal foi blefarite crônica. (IC de 95%, 0,08-0,96, p=0,043), história de tabagismo (IC 95%, 0,13-0,84, p=0,021), ectrópio (IC 95%, 0,004-0,26, p=0,001), queixa de lacrimejamento (95% IC, 1,11-3,52, p=0,02) e atividade ocupacional ao ar livre (IC 95%, 3,42-9,97, p<0,05). Conclusão: A estenose externa do ponto lacrimal é um distúrbio mais comum em pacientes idosos do que na população em geral. Atividade ocupacional ao ar livre, medicação antiglaucomatosa, ectrópio e tabagismo foram significativamente associados com estenose externa do ponto lacrimal. A decisão sobre tratamento cirúrgico deve ser dada após a avaliação completas dos fatores associados em cada paciente.


Subject(s)
Humans , Male , Female , Aged , Aged, 80 and over , Lacrimal Duct Obstruction/epidemiology , Turkey/epidemiology , Blepharitis/complications , Blepharitis/epidemiology , Smoking/adverse effects , Logistic Models , Prevalence , Cross-Sectional Studies , Risk Factors , Age Factors , Constriction, Pathologic , Lacrimal Apparatus/physiopathology , Lacrimal Apparatus/pathology , Lacrimal Duct Obstruction/etiology
20.
Arq. bras. oftalmol ; 80(3): 172-175, May-June 2017. tab, graf
Article in English | LILACS | ID: biblio-888117

ABSTRACT

ABSTRACT Purpose: To compared the ultrasound findings of the lacrimal sac between subjects with normal lacrimal systems those with chronic dacryocystitis. Methods: A retrospective study of 10 subjects with a normal lacrimal system (Group 1) and 10 with chronic dacryocystitis (Group 2) diagnosed according to B-mode ultrasound with a 10-MHz transducer and the direct-contact technique (AVISO, Quantel Medical) for lacrimal sac assessment. We analyzed the dimensions, features, and content of the sacs. Characteristics of the population: female: 6, Group 1; 8, Group 2; mean age 48.4 years (SD=19.9; range, 22-80 years), Group 1; 50.5 years (SD=15.5; range, 25-75 years), Group 2. Results: The dimensions of the lacrimal sac were as follows: anteroposterior 1.86 and 10.99 mm in Groups 1 and 2, respectively, p<0.0001; vertical 9.79 and 14.13 mm in Groups 1 and 2, respectively, p=0.049. Qualitative evaluation of the lacrimal sac contents showed hypoechogenic content in Group 1 (10, 100%) and hyperechogenic punctiform content in Group 2 (10, 100%) with partial filling in seven cases (70%). Conclusions: Ultrasonography can differentiate normal lacrimal sacs from sacs compromised by chronic dacryocystitis, thus being useful as an adjunct to clinical examination and surgical planning.


RESUMO Objetivo: Categorizar os achados ultrassonográficos do saco lacrimal em indivíduos com via lacrimal normal e em portadores de dacriocistite crônica. Métodos: Estudo retrospectivo de 20 indivíduos, 10 com via lacrimal normal (Grupo 1) e 10 com diagnóstico de dacriocistite crônica (Grupo 2) utilizando ultrassonografia modo B com transdutor de 10 MHz e técnica de contato (Aviso, Quantel Medical) para avaliar o saco lacrimal. Analisamos os seguintes parâmetros: dimensões, características e conteúdo. Resultados: Características da população estudada: sexo feminino: 6, Grupo 1; 8, Grupo 2; idade média: 48,4 anos (DP=19,93; variação, 22 a 80 anos), Grupo 1; 50,5 anos (DP=15,47; variação, 25 a 75 anos), Grupo 2. As dimensões do saco lacrimal foram aferidas: anteroposterior, 1,86 mm no Grupo 1 e 10,99 mm no Grupo 2, p<0,0001; vertical, 9,79 mm no Grupo 1 e 14,13 mm no Grupo 2, p=0,049. A avaliação qualitativa do conteúdo do saco lacrimal mostrou: conteúdo hipoecogênico no Grupo 1 (10, 100%); e conteúdo puntiforme hiperecogênico no Grupo 2 (10, 100%), com preenchimento parcial em 7 casos (70%). Conclusão: A ultrassonografia foi capaz de diferenciar a via lacrimal normal da acometida por dacriocistite crônica, e de determinar parâmetros úteis para suportar o acompanhamento clínico ou auxiliar no planejamento cirúrgico.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Dacryocystitis/pathology , Nasolacrimal Duct/pathology , Nasolacrimal Duct/diagnostic imaging , Organ Size , Case-Control Studies , Chronic Disease , Reproducibility of Results , Retrospective Studies , Ultrasonography/methods , Lacrimal Duct Obstruction/pathology , Lacrimal Duct Obstruction/diagnostic imaging
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