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Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study

INTRODUCTION: The dacryocystorhinostomy (DCR) procedure is linked to a high success rate; however, cases of tearing recurrence are not rare and should be managed efficiently. Thus, evaluating cases of DCR failure allows highlighting the factors significantly impacting the results in order to realize...

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Autores principales: El Bouhmadi, Khadija, Loudghiri, Myriam, Oukessou, Youssef, Rouadi, Sami, Abada, Redallah, Roubal, Mohamed, Mahtar, Mohamed
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473351/
https://www.ncbi.nlm.nih.gov/pubmed/37663685
http://dx.doi.org/10.1097/MS9.0000000000001039
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author El Bouhmadi, Khadija
Loudghiri, Myriam
Oukessou, Youssef
Rouadi, Sami
Abada, Redallah
Roubal, Mohamed
Mahtar, Mohamed
author_facet El Bouhmadi, Khadija
Loudghiri, Myriam
Oukessou, Youssef
Rouadi, Sami
Abada, Redallah
Roubal, Mohamed
Mahtar, Mohamed
author_sort El Bouhmadi, Khadija
collection PubMed
description INTRODUCTION: The dacryocystorhinostomy (DCR) procedure is linked to a high success rate; however, cases of tearing recurrence are not rare and should be managed efficiently. Thus, evaluating cases of DCR failure allows highlighting the factors significantly impacting the results in order to realize better controlled primary surgeries. MATERIAL AND METHOD: Twenty-eight patients were operated in our Otolaryngology Department for endoscopic revision of DCR failure between January 2019 and June 2022. Their clinical presentation, postoperative evolution, and findings of the primary and revision surgeries were assessed until the actual follow-up. RESULTS: The first surgery was based on an external approach in 17 patients and the bicanalicular silicone tube intubation was kept for a mean of 4.25 months. The recurrence delay varied from 0.5 to 9 months. Revision surgery revealed synechia in 10 patients, a completely closed DCR ostium in 22 patients (78.57%) by mucosal scarring and granulation, and lacrimal sac fibrosis in 16 patients (57.14%). A significant correlation was found between maintenance of the silicone intubation tube greater than or equal to 3 months and lacrimal sac fibrosis (P=0.016<0.05). CONCLUSION: Thus, better controlled primary surgeries with optimal exposure, wild marsupialisation of the lacrimal sac and no longer systematic bicanalicular intubation which should be dedicated to difficult anatomies and canalicular affections should guarantee better functional results.
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spelling pubmed-104733512023-09-02 Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study El Bouhmadi, Khadija Loudghiri, Myriam Oukessou, Youssef Rouadi, Sami Abada, Redallah Roubal, Mohamed Mahtar, Mohamed Ann Med Surg (Lond) Original Research INTRODUCTION: The dacryocystorhinostomy (DCR) procedure is linked to a high success rate; however, cases of tearing recurrence are not rare and should be managed efficiently. Thus, evaluating cases of DCR failure allows highlighting the factors significantly impacting the results in order to realize better controlled primary surgeries. MATERIAL AND METHOD: Twenty-eight patients were operated in our Otolaryngology Department for endoscopic revision of DCR failure between January 2019 and June 2022. Their clinical presentation, postoperative evolution, and findings of the primary and revision surgeries were assessed until the actual follow-up. RESULTS: The first surgery was based on an external approach in 17 patients and the bicanalicular silicone tube intubation was kept for a mean of 4.25 months. The recurrence delay varied from 0.5 to 9 months. Revision surgery revealed synechia in 10 patients, a completely closed DCR ostium in 22 patients (78.57%) by mucosal scarring and granulation, and lacrimal sac fibrosis in 16 patients (57.14%). A significant correlation was found between maintenance of the silicone intubation tube greater than or equal to 3 months and lacrimal sac fibrosis (P=0.016<0.05). CONCLUSION: Thus, better controlled primary surgeries with optimal exposure, wild marsupialisation of the lacrimal sac and no longer systematic bicanalicular intubation which should be dedicated to difficult anatomies and canalicular affections should guarantee better functional results. Lippincott Williams & Wilkins 2023-07-15 /pmc/articles/PMC10473351/ /pubmed/37663685 http://dx.doi.org/10.1097/MS9.0000000000001039 Text en Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by/4.0/This is an open access article distributed under the Creative Commons Attribution License 4.0 (https://creativecommons.org/licenses/by/4.0/) (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/)
spellingShingle Original Research
El Bouhmadi, Khadija
Loudghiri, Myriam
Oukessou, Youssef
Rouadi, Sami
Abada, Redallah
Roubal, Mohamed
Mahtar, Mohamed
Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study
title Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study
title_full Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study
title_fullStr Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study
title_full_unstemmed Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study
title_short Evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study
title_sort evaluation of the endoscopic revision of dacryocystorhinostomy failure cases: a cohort study
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10473351/
https://www.ncbi.nlm.nih.gov/pubmed/37663685
http://dx.doi.org/10.1097/MS9.0000000000001039
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