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@#AIM: To analyze the curative effect and safety of modified dacryocystorhinostomy with simple anterior flap anastomosis in the treatment of chronic dacryocystitis.<p>METHODS: A total of 99 patients(113 affected eyes)with chronic dacryocystitis who underwent dacryocystorhinostomy in the hospital between March 2016 and July 2018 were enrolled in the retrospective study. They were divided into the traditional group(traditional dacryocystorhinostomy, 46 cases, 52 affected eyes)and the modified group(modified surgery with simple anterior flap anastomosis, 53 cases, 61 affected eyes)according to the surgical procedures. The surgical results, rates of granulation tissue formation around the anastomotic stoma at different time after surgery, rates of nasal mucosal epithelialization, size of the anastomotic stoma, the occurrence of surgical complications and the recurrence rate during 1a of follow-up were compared between the two groups.<p>RESULTS: The grade of curative effect in the modified group was better than the traditional group(75.0% <i>vs </i>95.1%)during 6mo of follow-up(<i>P</i><0.05). The total cure rate was higher than that of the traditional group(<i>P</i><0.005). The rates of granulation tissue formation(3.8%, 5.7%, 9.4%)in the modified group at 1mo, 3mo and 6mo after surgery were lower than those in the traditional group(64.2% <i>vs</i> 39.1%, <i>P</i><0.001). The rate of nasal mucosal epithelialization in the modified group was higher than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2, <i>P</i><0.01)at 1mo after surgery. The area of anastomotic stoma in the modified group was larger than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2,<i>P</i><0.01)at 6mo after surgery. The incidence rates of postoperative hemorrhage and complication in the modified group and the recurrence rate in 1y of follow-up were lower than those in the traditional group(<i>P</i><0.05).<p>CONCLUSION: The cure rate of patients undergoing modified dacryocystorhinostomy with simple anterior flap anastomosis is higher than those undergoing traditional surgery. The former can promote nasal mucosal epithelialization, maintain the size of anastomotic stoma and prevent the formation of surrounding granulation tissue. It is safe and effective, with few complications and low recurrence rate.
RESUMEN
@#AIM: To analyze the curative effect and safety of modified dacryocystorhinostomy with simple anterior flap anastomosis in the treatment of chronic dacryocystitis.<p>METHODS: A total of 99 patients(113 affected eyes)with chronic dacryocystitis who underwent dacryocystorhinostomy in the hospital between March 2016 and July 2018 were enrolled in the retrospective study. They were divided into the traditional group(traditional dacryocystorhinostomy, 46 cases, 52 affected eyes)and the modified group(modified surgery with simple anterior flap anastomosis, 53 cases, 61 affected eyes)according to the surgical procedures. The surgical results, rates of granulation tissue formation around the anastomotic stoma at different time after surgery, rates of nasal mucosal epithelialization, size of the anastomotic stoma, the occurrence of surgical complications and the recurrence rate during 1a of follow-up were compared between the two groups.<p>RESULTS: The grade of curative effect in the modified group was better than the traditional group(75.0% <i>vs </i>95.1%)during 6mo of follow-up(<i>P</i><0.05). The total cure rate was higher than that of the traditional group(<i>P</i><0.005). The rates of granulation tissue formation(3.8%, 5.7%, 9.4%)in the modified group at 1mo, 3mo and 6mo after surgery were lower than those in the traditional group(64.2% <i>vs</i> 39.1%, <i>P</i><0.001). The rate of nasal mucosal epithelialization in the modified group was higher than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2, <i>P</i><0.01)at 1mo after surgery. The area of anastomotic stoma in the modified group was larger than that in the traditional group(25.63±4.76 <i>vs </i>11.34±3.52mm2,<i>P</i><0.01)at 6mo after surgery. The incidence rates of postoperative hemorrhage and complication in the modified group and the recurrence rate in 1y of follow-up were lower than those in the traditional group(<i>P</i><0.05).<p>CONCLUSION: The cure rate of patients undergoing modified dacryocystorhinostomy with simple anterior flap anastomosis is higher than those undergoing traditional surgery. The former can promote nasal mucosal epithelialization, maintain the size of anastomotic stoma and prevent the formation of surrounding granulation tissue. It is safe and effective, with few complications and low recurrence rate.
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@#AIM: To compare the intraoperative bleeding and the postoperative therapeutic effect of two nasal mucosal incisions in nasal endoscopic dacryocystorhinostomy.<p>METHODS: Retrospective study. Sixty-three patients(66 eyes)with chronic dacryocystitis diagnosed by ophthalmology and treated by nasal endoscopic dacryocystorhinostomy in our hospital from June 2016 to May 2018 were collected. According to the different grouping of the base of nasal mucosal flap, dacryocystorhinostomy was performed through nasal mucosal incision with middle turbinate axilla as base in group A, and dacryocystorhinostomy was performed through nasal mucosal incision with maxillary line as base in group B. The patients were followed up to 6mo after operation, and the intraoperative bleeding and postoperative efficiency were compared between the two groups.<p>RESULTS: There was significant difference in intraoperative bleeding between the two groups.(χ<sup>2</sup>=11.803, <i>P</i><0.05). The postoperative efficiency of patients in the two groups was not statistically significant(82% <i>vs</i> 73%, <i>P</i>>0.05).<p>CONCLUSION: The nasal mucosal incision with the middle turbinate axillary region as the base was associated with more bleeding during the operation, while the nasal mucosal incision with the maxillary line as the base was less bleeding during the operation, and there was no significant difference in the postoperative treatment effect.
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PURPOSE: To evaluate the surgical result of lacrimal surgery with total removal of the nasal mucosal flap. METHODS: Lacrimal surgery was performed in 30 eyes of 26 patients, by external approach without the nasal mucosal flap from February 2001 to August 2002. The surgical method was similar to conventional dacryocystorhinostomy, but the nasal mucosa of the osteotomy site was removed with a No.11 Bard-Parker blade and Westcott scissors. After insertion of a silicone tube, the anterior flap of the lacrimal sac was sutured to the soft tissues around the osteotomy site. Surgical efficacy was evaluated after a follow-up period of 7 22 months (average, 11.5 months). RESULTS: The primary success rate was 96.7% (29/30 eyes). We performed revision of mucosa ostium in the one failed eye, thereby raising the final success rate to 100%. The size of mucosa ostium was 0.7 3.0 mm (average 1.17 mm). CONCLUSIONS: Satisfactory surgical results were obtained without anastomosis of the lacrimal sac or the nasal mucosa during external approach, lacrimal surgery. We suggest that this method is a good surgical procedure in external approach, lacrimal surgery.