Associated factors of functional failure of external dacryocystorhinostomy

作者：Lee Min Joung; Khwarg Sang In^*; Choung Ho Kyung; Kim Namju

来源：Canadian Journal of Ophthalmology, 2014, 49(1): 40-44.

DOI：10.1016/j.jcjo.2013.08.006

Objective: To evaluate the incidence and associated factors of functional failure of anatomically patent external dacryocystorhinostomy (DCR). %26lt;br%26gt;Design: Prospective, nonrandomized case series. %26lt;br%26gt;Participants: Thirty-four consecutive patients who underwent external DCR at the oculoplasty clinic in the Department of Ophthalmology, Seoul National University Hospital between December 2008 and July 2009. %26lt;br%26gt;Methods: All patients underwent external DCR for primary acquired nasolacrimal duct obstruction. The silicone tubes were removed around 6 months after the DCRs, and patients were examined 1 month after tube removal. Anatomical patency was evaluated by a nasal endoscopic dye test and lacrimal syringing test. Tearing symptoms were evaluated using Munk%26apos;s scoring system. Patients were divided into 2 groups according to the presence of epiphora symptom; a functional success and functional failure group, and the incidence of functional failure were calculated. Potential associated factors were also compared between 2 groups. %26lt;br%26gt;Results: This study involved 50 eyes of 34 patients, and 8 eyes of 6 patients showed significant epiphora in spite of anatomical patency (16% functional failure). We compared associated factors between 42 functionally successful and 8 functionally failed DCRs. Among variables studied, demographic factors and intraoperative surgical findings were not statistically different between the 2 groups. With respect to intranasal endoscopic findings, the shape of the rhinostomy showed significant differences between the 2 groups (p = 0.03, Fisher%26apos;s exact test). In the functional failure group, there were no flat shape rhinostomies. Three showed alcove shape rhinostomies, and the other 5 showed cavern shape rhinostomies. %26lt;br%26gt;Conclusions: Among anatomically patent DCRs, the incidence of persistent epiphora was 16%. The shape of rhinostomy is a possible associated factor for functional failure after external DCR.

• 出版日期2014-2