ABSTRACT
This article reviews etiological factors in the development of lacrimal punctal stenosis, modern diagnostic techniques, as well as both conservative and surgical treatment methods. The presented analysis is based on data from 67 literary sources, which provide information on conventional and high-tech examination and treatment methods of patients with lacrimal punctal stenosis. Particular attention is paid to various aspects of punctoplasty - the most common surgical intervention used to treat this pathology.
Subject(s)
Dacryocystorhinostomy , Eyelid Diseases , Lacrimal Apparatus Diseases , Constriction, Pathologic/diagnosis , Constriction, Pathologic/etiology , Constriction, Pathologic/therapy , Dacryocystorhinostomy/adverse effects , Dacryocystorhinostomy/methods , Humans , Retrospective StudiesABSTRACT
The article reviews the literature devoted to modern intraoperative methods of preventing cicatricial process at the site of dacryostoma after endonasal endoscopic dacryocystorhinostomy. Despite the constant improvement of the surgery technique, complications in the postoperative period still occur. They include the formation of granulation tissue at the sites of dacryostoma, synechiae in the nasal cavity, or narrowing of the dacryostoma, which ultimately leads to a relapse of the disease. The main prevention methods are construction of flaps from the medial wall of the lacrimal sac, from mucosa of the nasal cavity, and intubation of the dacryostoma with the lacrimal implant. They are used separately and in various combinations.
Subject(s)
Dacryocystitis , Dacryocystorhinostomy , Nasolacrimal Duct , Endoscopy , Humans , Intubation , RecurrenceABSTRACT
The article reviews the literature on methods of evaluating the morphological and functional state of the eyelids in chronic blepharitis. Development of methods continues together with further research on the etiology and pathogenesis of the disease.
Subject(s)
Blepharitis , Chronic Disease , Eyelids , HumansABSTRACT
Ostium closure due to local reparative processes is the most common cause of recurrence after endoscopic endonasal dacryocystorhinostomy (DCR), but as yet poorly studied. AIM: To perform morphological study of reparative processes at osteotomy site after endoscopic endonasal DCR. MATERIAL AND METHODS: The study included 18 patients (18 women) aged 62.59±10.07 years with nasolacrimal duct obstruction, who underwent endoscopic endonasal DCR (P.J. Wormald modification). Osteotomy site biopsies were taken on days 2, 5, 7, 10, 14, 21, 28, and 60 after the surgery. All the samples were stained with haematoxylin and eosin. For further details on cellular composition of inflammatory infiltrate, 54 samples were also processed into semi-thin sections. The slides were then viewed under Leica DM-2500 (Leica, Germany) photomicroscope. Leica DFC320 digital camera and ImageScope Color software were used for image acquisition and analysis. RESULTS: Morphological examination revealed the predominance of inflammatory cells in biopsy material on day 1 after DCR. On day 14, the number of cells would usually be reduced indicating the completion of the exudative phase of inflammation. Since then, activated fibroblasts prevailed over the rest of cellular elements. Twenty eight days after DCR, proliferating fibroblasts and collagen fibers were present. Sixty days after the surgery, fibrillar component prevailed over cells and showed compaction. CONCLUSION: Our results demonstrate that the reparation process nears completion before day 60 after the surgery. A series of morphological examinations of biopsy material from osteotomy sites has revealed individual features of reparation in nasal and lacrimal sac mucosa after endoscopic endonasal DCR.
Subject(s)
Dacryocystorhinostomy , Lacrimal Duct Obstruction/pathology , Nasolacrimal Duct , Aged , Biopsy/methods , Dacryocystorhinostomy/adverse effects , Dacryocystorhinostomy/methods , Female , Humans , Male , Middle Aged , Nasolacrimal Duct/diagnostic imaging , Nasolacrimal Duct/pathology , Natural Orifice Endoscopic Surgery/adverse effects , Natural Orifice Endoscopic Surgery/methods , Osteotomy/methods , RecurrenceABSTRACT
The article presents the results of a long-term study on application of cytological examination in dacryology. A total of 194 patients (288 eyes) with dacryostenosis, dacryocystitis, and obliteration of lacrimal canaliculi orifices were assessed. Pathogenically oriented conservative treatment, in accordance with the results of clinical, instrumental, and cytological examination, was given to all patients with dacryostenosis. Patients with dacryocystitis and lacrimal canaliculi orifice obliteration received surgical treatment: microendoscopic dacryocystorhinostomy, transcanalicularis laser dacryocystorhinostomy, and microendoscopic canaliculocystorhinostomy. Cytological examination, among other methods, was used to evaluate treatment results. The method has been demonstrated as objective and can be included into the assessment and follow-up algorithm for patients with lacrimal ducts pathology.
Subject(s)
Cytological Techniques/methods , Lacrimal Apparatus Diseases/pathology , Lacrimal Apparatus/pathology , Adult , Aged , Female , Follow-Up Studies , Humans , Male , Middle Aged , Reproducibility of Results , Time FactorsABSTRACT
Cytologic investigation was performed in patients with dacryocystitis after microscopic endonasal dacryocystorhinostomy and in patients with lacrimal canaliculi orifice obstruction after microscopic endonasal canaliculocystorhinostomy. It allowed to monitor healing process, extubation time and to develop measures for prevention of dacryostoma cicatrisation.
