Short-Term Clinical Results of Amniotic Membrane Application to Endonasal Dacryocystorhinostomy

ABSTRACT

PURPOSE: To evaluate the short-term surgical results of Merocel(R) nasal packing wrapped with human amniotic membrane on the internal ostium during endonasal dacryocystorhinostomy (DCR). METHODS: Sixty patients who underwent endonasal DCR to treat nasolacrimal duct obstruction from October 2005 to April 2006 were enrolled in this prospective study. The patients were divided into two groups 30 patients treated with Merocel(R) packing wrapped with amniotic membrane were assigned to group 1, and the remaining 30 patients were assigned to group 2. During the follow-up period, the authors evaluated surgical wound healing, the incidence of granuloma, and the patency of the internal ostium. RESULTS: Success rates at 6 months after surgery were higher in group 1 than in group 2, but these rates showed no statistically significant difference between the two groups (group 1 93.3%, group 2 86.7%, p=0.67). The time for mean wound healing in group 1 was significantly shorter than that in group 2 (group 1 4.8+/-1.5 weeks, group 2 7.3+/-1.5 weeks, p< 0.001). The incidence of granuloma in group 1 was lower than that in group 2 at 2 months after surgery (group 1 13% (4/30), group 233% (14/30), p=0.04). However, there was no difference of granuloma formation between the two groups at 6 months postoperatively (group 1 33% (11/30), group 2 46% (14/30)). CONCLUSIONS: The authors believe that the use of Merocel(R) packing wrapped with amniotic membrane after endonasal DCR might decrease postoperative inflammation, accelerate wound healing, and decrease granuloma formation in the early postoperative period.