The results of utilising endoscopic DCR as the main therapy for acute dacryocystitis in adults are highlighted in the current study. 30 patients with nasolacrimal duct block who presented with acute dacryocystitis and accompanying sequelae, including preseptal cellulitis, lacrimal empyema, with or without a spontaneous lacrimal fistula, were the subject of a retrospective case series investigation.
Antibiotics taken orally were begun at the same time. All individuals were
taken while being sedated intravenously. The same surgeon performed surgery on
each of the chosen patients. The effectiveness was measured by how much the
discomfort, edoema, and epiphora had decreased. Following surgery, a follow-up
was conducted at 1, 4, and 6 months. Lacrimal syringing was performed to check
the sac's patency at each subsequent visit. Every time, endonasal cleaning was
performed on the granulation tissue. The anterior end of the middle turbinate
received intranasal infiltration in all planes. The mucosal flap was raised
while still preserving hemostasis. Using bony markers such the anterior end of
the middle turbinate and the posterior edge of the frontal process of the
maxilla, bone over the medial wall of the lacrimal sac was excised. In contrast
to other research, which focused on lacrimal empyemas, this study shown that
endoscopic DCR may be utilised to treat sequelae of acute dacryocystitis such
cellulitis and fistulas. In this trial, no DCR stents were used.
The procedure had a 92.85 percent success rate.
ll procedures went smoothly, and the enlarged sac region made it much simpler to
locate the surgical site. Due to the existence of a deviated nasal septum,
several of the patients received a concomitant septoplasty procedure. No DCR
stents or tubes were utilised throughout the procedure. The edoema and epiphora
were lessened on the first post-operative day. All of the patients' pain
subsided as well, however in 4 of the patients, the pain subsided gradually
over the course of 2 days. Patent lacrimal channels were seen with lacrimal
syringing.
Following treatment, at 1 week and 1 month, the osteotomy was suctioned
endonasally clear of all the granulation tissue. At a 6-month checkup, the
osteotomy was still intact in 26 individuals.
The combined use of endo-DCR, antibiotics, and anti-inflammatory medications
resulted in a 92.5% success rate.
Author (s) Details:
Reshma Pathan,
Department of Ophthalmology, Navodaya Medical College, Raichur, Karnataka, India.
Rizwan Pathan,
Department of ENT, Navodaya Medical College, Raichur, Karnataka, India.
Ayisha Afreen,
Department of Ophthalmology, Navodaya Medical College, Raichur, Karnataka, India.
Please see the link here: https://stm.bookpi.org/CODHR-V1/article/view/7429
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