Subject(s)
Dacryocystorhinostomy , Lacrimal Duct Obstruction , Nasolacrimal Duct , Humans , Lacrimal Duct Obstruction/congenital , Lacrimal Duct Obstruction/diagnosis , Lacrimal Duct Obstruction/therapy , Nasolacrimal Duct/abnormalities , Nasolacrimal Duct/diagnostic imaging , Dacryocystorhinostomy/methods , Practice Guidelines as TopicABSTRACT
Foreign objects sometimes enter the lacrimal sac. Here, we report the case of a patient with many comb-shaped eyelashes in the lacrimal sac and discuss the potential of using dacryoendoscopy to detect and remove foreign bodies from the lacrimal apparatus. A 65-year-old woman with a teary eye underwent dacryoendoscopy. There was no abnormality in the canaliculi. The internal ostium was blocked by a large number of black, comb-shaped eyelashes. Numerous bunched eyelashes covered with small white debris were found in the upper part of the lacrimal sac. No eyelash bundles were present from the lower lacrimal sac to the nasolacrimal duct, and the mucosa was normal. The saline was able to pass through; however, the lower part of the nasolacrimal duct was narrowed into a funnel shape. We widened it with a sheath while observing the endoscopy images. Eyelashes were flushed from the lacrimal sac through the nasolacrimal duct using the sheath and saline flow. A lacrimal tube was placed for 2 months and removed, and then the patient healed without dacryocystorhinostomy.
ABSTRACT
We report a 24-month-follow-up study of argon plasma coagulation of the inferior turbinate (APC) in patients with perennial nasal allergy. This was a retrospective study, in which 41 patients with perennial allergic rhinitis were treated by inferior turbinate reduction using APC. The grades of nasal stuffiness, rhinorrhea, sneezing and the daily activity impairment caused by these nasal symptoms were evaluated before and then 6, 9, 12, 15, 18, 21, and 24 months after APC, using a questionnaire graded on a four-point scale according to the Severity Criteria of Symptoms of Nasal Allergy issued by the Japanese Society of Allergology. Both nasal stuffiness and any daily activity impairment significantly improved 6 months after APC. Twenty four months after APC, 8/10 (80%) of the patients reported mild or no stuffiness and 9/10 (90%) of the patients reported mild or no daily activity impairement. Neither rhinorrhea nor sneezing were significantly improved during this study. Of the 41 patients 18 (43.9%) received no additional treatment. A second APC treatment was administered to 10/41 (24.4%) patients during follow-up period. Additional conservative medications were needed in 15/41 (36.6%) patients. Among the patients uncontrolled by conservative medical treatment, inferior turbinate reduction using APC provides significant relief in a 24-month-follow-up from nasal stuffiness and daily activity impairment.
Subject(s)
Laser Coagulation/methods , Lasers, Gas/therapeutic use , Rhinitis, Allergic, Perennial/surgery , Turbinates/surgery , Adolescent , Adult , Aged , Argon , Child , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Surveys and Questionnaires , Treatment Outcome , Young AdultABSTRACT
The aim of this study was to clarify the short-term effects of argon plasma coagulation (APC) of the inferior turbinate in patients with perennial nasal allergy. In a retrospective study, 32 patients with perennial allergic rhinitis were treated by inferior turbinate reduction using APC. Grades of nasal stuffiness, rhinorrhea, sneezing, nasal airflow resistance (NAR) and overall seriousness were evaluated before and then 1-4 and 8 weeks after APC. Subjective symptoms were assessed using a questionnaire in which nasal stuffiness, rhinorrhea and sneezing were graded on a four-point scale (severe, moderate, mild and none) using the Severity Criteria of Symptoms of Nasal Allergy issued by the Japanese Society of Allergology. NAR was measured using active anterior rhinomanometry (AAR) at the 100 Pa point; this was deemed to be an objective measurement of nasal obstruction. The numbers of patients examined before and 1-4 and 8 weeks after APC were 32, 31, 25, 17, 18 and 14, respectively. Both nasal stuffiness and NAR were significantly improved 2 weeks after APC, overall seriousness was significantly improved after 3 weeks and rhinorrhea was improved after 4 weeks. Sneezing did not significantly improve during this study. There was no significant change in the grades of the examined parameters during the period between 4 and 8 weeks after APC. The beneficial effects of APC begin to appear within 2 weeks after APC and no further improvement after about 4 weeks.
