Clinical Perspectives, Surgical Approach, Outcome and Limitations of External Dacryocystorhinostomy | Chapter 11 | Medical Research and Its Applications Vol. 5

External dacryocystorhinostomy (DCR) is a surgical procedure aimed at restoring the drainage pathway of tears in patients suffering from nasolacrimal duct obstruction. This chapter provides an in-depth exploration of the surgical technique, indications, clinical outcomes, postoperative care and limitations associated with external DCR.

 

Author(s)details:-

 

Harikrishnan Marappan
Department of Ophthalmology, Karuna Institute of Medical Sciences, Palakkad, Kerala, India.

 

Please See the book here :- https://doi.org/10.9734/bpi/mria/v5/648

Evaluating the Results of Endoscopic Dacryocystorhinostomy as Primary Treatment for Acute Dacryocystitis | Chapter 9 | Current Overview on Disease and Health Research Vol. 1

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

A Study on Inverting Papilloma of the Lacrimal Sac: A Case Report and Literature Review | Chapter 16 | Recent Developments in Medicine and Medical Research Vol. 6

 The goal of this paper is to describe a rare instance of inverting papilloma coming from the lacrimal sac, as well as to evaluate the literature on inverting papilloma originating from the lacrimal sac.

Case report as a method.

Results: In the lacrimal sac, inverting papilloma is unusual. The maxillary sinus, ethmoid sinus, and lateral wall of the nasal cavity are the most common sites. This is the storey of a 69-year-old Filipino man who had a two-year history of a gradually increasing left medial canthal tumour with tearing. There had been no previous trauma in the patient's life. There was no ophthalmoplegia, vision problems, proptosis, or pain, but there was a superolateral globe displacement. A heterogeneously increasing mass spreading to the ipsilateral nasolacrimal canal and nasal cavity was discovered on an orbital CT scan, generating a mass effect. There was a worrisome hyperostosis area noted. For co-management, the patient was sent to the Department of Otolaryngology Head & Neck Surgery. Histopathology detected inverted papilloma after a punch biopsy. Anterior maxillectomy and dacryocystectomy were combined surgically via a lateral rhinotomy technique. There was adhesion to bone in the area of the lacrimal sac that corresponded to the area of hyperostosis on CT-scan intraoperatively. The recovery was uneventful, with visual acuity and extraocular muscle movement remaining intact.

Conclusion: This is a case of an inverted papilloma involving the lacrimal sac and nasolacrimal duct that was treated with a combination of anterior maxillectomy and dacryocystectomy for complete excision using a lateral rhinotomy method. To reduce the risk of recurrence, we recommended total removal of the tumour. Intraoperative findings that matched CT scan findings verified the origin in the lacrimal sac area.

Author(S) Details

Elaine Marie Y. Omana
Department of Ophthalmology, Rizal Medical Center, Pasig City, Philippines.

Franklin P. Kleiner
Department of Ophthalmology, Rizal Medical Center, Pasig City, Philippines.

View Book:- https://stm.bookpi.org/RDMMR-V6/article/view/4531