Wednesday 30 September 2015

Double Posterior Based Flap Technique in Primary Endoscopic Dacrocystorhinostomy with and without use of Lacrimal Stent

Pradeep Pradhan*, Swagatika Samal, Priti Lal and VP Venkatachalam
Abstract: 
Objective: To demonstrate the double posterior based flap technique in primary endoscopic dacrocystorhinostomy and to compare the long-term surgical outcomes between patients with and without use of lacrimal stent in chronic nasolacrimal duct obstruction.
Material method: Total 28 patients with chronic nasolacrimal duct obstruction were included in the study from September 2012 to august 2014. All patients underwent Endoscopic dacrocystorhinostomy with posterior based double lacrimal and mucosal flap technique. In 14 patients lacrimal stents were put for 2 weeks, and in rest 14 patients were operated without using the stent. Patients were evaluated 1 month, 3 months and 1 year after the surgery to check the lacrimal patency and to look for the complications associated with the procedure.
Results: Out of 28 cases, recurrences of symptoms were noted in 2 (7.14%) cases, 1(7.14%) from stenting group and 1(7.14%) from non stenting group at the end one month and 3 months. At the end of 1 year, only 24 patients attended the outpatient clinic (11 from non stenting group and 13 from stenting group) and of them 1(9.09%) from non stenting group and 2(15.38%) from stenting group had recurrence of symptoms. The success rate of procedure in non stent group was 90.91% as compared to the stent group which was 84.62% at the end of 1 year. None of the patients in both groups had any major intraoperative or postoperative complications.
Conclusion: Double posterior based mucosal and lacrimal flap technique in Primary EDCR is an effective surgical technique associated with satisfactory outcome. No significant difference in the results (p=0.588) and complications were noted between non stenting group stenting group.

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