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Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay
PURPOSE: To elucidate the role of syringing in assessing nasolacrimal duct (NLD) stenosis and non-anatomical functional NLD delay. METHODS: Consecutive adult patients with epiphora attending a tertiary lacrimal clinic from June 2011 to March 2021 were reviewed. Cases with evidence of canalicular ste...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Berlin Heidelberg
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9418293/ https://www.ncbi.nlm.nih.gov/pubmed/35460361 http://dx.doi.org/10.1007/s00417-022-05654-1 |
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author | Shapira, Yinon Juniat, Valerie Macri, Carmelo Selva, Dinesh |
author_facet | Shapira, Yinon Juniat, Valerie Macri, Carmelo Selva, Dinesh |
author_sort | Shapira, Yinon |
collection | PubMed |
description | PURPOSE: To elucidate the role of syringing in assessing nasolacrimal duct (NLD) stenosis and non-anatomical functional NLD delay. METHODS: Consecutive adult patients with epiphora attending a tertiary lacrimal clinic from June 2011 to March 2021 were reviewed. Cases with evidence of canalicular stenosis or other identifiable causes of epiphora were excluded. Following syringing, patients were investigated with dacryocystography (DCG) and dacryoscintigraphy (DSG). The sensitivity and specificity of syringing were evaluated using the combined findings on DCG and DSG. RESULTS: A total of 289 symptomatic lacrimal systems (197 patients; mean age 65.5 ± 14.9 years, 66% females) were included. More than one-third of cases with both normal DCG and DSG were noted to have some degree of reflux on syringing (specificity = 65.1%, 95% CI 50.2–77.6%). The sensitivities were considerably low for NLD stenosis (i.e., stenosis on DCG and delay on DSG) and for functional NLD delay (i.e., normal DCG and delay on DSG), of which 43.7% (95% CI 32.2–55.9%) and 54.3% (95% CI 45.7–62.7%) had full patency on syringing, respectively (p = 0.17). CONCLUSIONS: Full patency on syringing was unreliable for ruling out NLD stenosis and functional delay. Furthermore, a positive syringing may be associated with functional NLD delay and cannot reliably differentiate it from stenosis. [Image: see text] |
format | Online Article Text |
id | pubmed-9418293 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Springer Berlin Heidelberg |
record_format | MEDLINE/PubMed |
spelling | pubmed-94182932022-08-28 Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay Shapira, Yinon Juniat, Valerie Macri, Carmelo Selva, Dinesh Graefes Arch Clin Exp Ophthalmol Oculoplastics and Orbit PURPOSE: To elucidate the role of syringing in assessing nasolacrimal duct (NLD) stenosis and non-anatomical functional NLD delay. METHODS: Consecutive adult patients with epiphora attending a tertiary lacrimal clinic from June 2011 to March 2021 were reviewed. Cases with evidence of canalicular stenosis or other identifiable causes of epiphora were excluded. Following syringing, patients were investigated with dacryocystography (DCG) and dacryoscintigraphy (DSG). The sensitivity and specificity of syringing were evaluated using the combined findings on DCG and DSG. RESULTS: A total of 289 symptomatic lacrimal systems (197 patients; mean age 65.5 ± 14.9 years, 66% females) were included. More than one-third of cases with both normal DCG and DSG were noted to have some degree of reflux on syringing (specificity = 65.1%, 95% CI 50.2–77.6%). The sensitivities were considerably low for NLD stenosis (i.e., stenosis on DCG and delay on DSG) and for functional NLD delay (i.e., normal DCG and delay on DSG), of which 43.7% (95% CI 32.2–55.9%) and 54.3% (95% CI 45.7–62.7%) had full patency on syringing, respectively (p = 0.17). CONCLUSIONS: Full patency on syringing was unreliable for ruling out NLD stenosis and functional delay. Furthermore, a positive syringing may be associated with functional NLD delay and cannot reliably differentiate it from stenosis. [Image: see text] Springer Berlin Heidelberg 2022-04-23 2022 /pmc/articles/PMC9418293/ /pubmed/35460361 http://dx.doi.org/10.1007/s00417-022-05654-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Oculoplastics and Orbit Shapira, Yinon Juniat, Valerie Macri, Carmelo Selva, Dinesh Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay |
title | Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay |
title_full | Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay |
title_fullStr | Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay |
title_full_unstemmed | Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay |
title_short | Syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay |
title_sort | syringing has limited reliability in differentiating nasolacrimal duct stenosis from functional delay |
topic | Oculoplastics and Orbit |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9418293/ https://www.ncbi.nlm.nih.gov/pubmed/35460361 http://dx.doi.org/10.1007/s00417-022-05654-1 |
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