Evaluation of dacryocystorhinostomy failure with computed tomographic dacryocystography

Sabhia Jan; Apoorva .; Junaid S. Wani; Raheel Riaz; Ovais Nazir

doi:10.18203/2320-6012.ijrms20175130

Authors

Sabhia Jan Department of Ophthalmology, SHKM Government Medical College, Mewat, Haryana, India
Apoorva . Department of Ophthalmology, SHKM Government Medical College, Mewat, Haryana, India
Junaid S. Wani Department of Ophthalmology, Government Medical College, Srinagar, Jammu, India
Raheel Riaz Department of Ophthalmology, Government Medical College, Srinagar, Jammu, India
Ovais Nazir Department of Anaesthesiology, Lady Hardinge Medical College, New Delhi, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20175130

Keywords:

Computed tomographic dacryocystography, Computed tomography, Dacryocystorhinostomy

Abstract

Background: The purpose of this study is to evaluate the causes of failure of dacryocystorhinostomy by computed dacryocystography (CT-DCG).

Methods: CT-DCG was done in 38 patients of failed DCR of either sex in the age group of 16-60 years, the radiologist blinded to the clinical status of the patient evaluated position and size of bony ostium, soft tissue scarring, bony regrowth, secondary stenosis of canaliculi, synechiae between the ostium and nasal septum and anatomic variations in nasal cavity, turbinates or nasal septum.

Results: The most common causes of failure in our study were inappropriate size of osteotomy window in 34 patients (84.47%), inappropriate location of osteotomy window in 31 patients (81.57%), fibrous tissue scarring at osteotomy window in 22 patients (57.89%), the other causes were bilateral concha bullosa in 2 patients, ethmoidal sinusitis in 2 patients, common canalicular block in 1 patient, faulty passage into ethmoidal sinus in 1 patient and no osteotomy window seen in patient.

Conclusions: CT-DCG is a valuable imaging tool to evaluate DCR failure before re-operation. In our study CT-DCG showed that small size of osteotomy window, inappropriate position of osteotomy window and fibrous tissue scarring at osteotomy window were frequently seen causative factors of DCR failure.

Metrics

Metrics Loading ...

References

Gauba V. External versus endonasal dacryocystorhinostomy in a specialized lacrimal surgery center. Sau J Ophthalmol. 2014;28(1):36-9.

Simon GJ, Joseph J, Lee S, Schwarcz RM, McCann JD, Goldberg RA. External versus endoscopic dacryocystorhinostomy for acquired nasolacrimal duct obstruction in a tertiary referral center. Ophthalmol. 2005;112(8):1463-8.

Vivekanand U, Gonsalves S. Etiologies of Failed External Dacryocystorhinostomy-A Case Series. Indidan journal of applied research. 2014;4(3).

Jin HR, Yeon JY, Choi MY. Endoscopic dacryocystorhinostomy: creation of a large marsupialized lacrimal sac. J Kore Medic Sci. 2006;21(4):719-23..

Kim NJ, Kim JH, Hwang SW, Choung HK, Lee YJ, Khwarg SI. Lacrimal silicone intubation for anatomically successful but functionally failed external dacryocystorhinostomy. Kore J Ophthalmol. 2007;21(2):70-3.

Welham RA, Wulc AE. Management of unsuccessful lacrimal surgery. Brit J Ophthalmol. 1987;71(2):152-7.

Boboridis KG, Bunce C, Rose GE. Outcome of external dacryocystorhinostomy combined with membranectomy of a distal canalicular obstruction. Ame J ophthalmol. 2005;139(6):1051-5.

Pradham B. Outcome of Endoscopic DCR at TUTH. Nepalese J ENT Head Neck Surg. 2012;2(1):20-1.

Glatt HJ, Chan AC, Barrett L. Evaluation of dacryocystorhinostomy failure with computed tomography and computed tomographic dacryocystography. Ame J Ophthalmol. 1991;112(4):431-6.

Gokcek A, Argin MA, Altintas AK. Comparison of failed and successful dacryocystorhinostomy by using computed tomographic dacryocystography findings. Euro J Ophthalmol. 2005;15(5):523-9.

Udhay P, Noronha OV, Mohan RE. Helical computed tomographic dacryocystography and its role in the diagnosis and management of lacrimal drainage system blocks and medial canthal masses. Ind J Ophthalmol. 2008;56(1):31.

Jordan DR, McDonald H. Failed dacryocystorhinostomy: the sump syndrome. Ophthal Surg. 1993;24(10):692-3.

Welham RA, Wulc AE. Management of unsuccessful lacrimal surgery. Brit J Ophthalmol. 1987;71(2):152-7.

Dolman PJ. Comparison of external dacryocystorhinostomy with nonlaser endonasal dacryocystorhinostomy. Ophthalmol. 2003;110(1):78-84.

McLachlan DL, Shannon GM, Flanagan JC. Results of dacryocystorhinostomy: analysis of the reoperations. Ophthalmic surg. 1980;11(7):427-30.

Smith BC. Ophthalmic plast reconstructive surgery. St Louis CV Mosby. 1987;12:907-76.

Roper-Hall MJ. Stallard’s Eye Surgery, 7th ed. London and Boston: Butterworth-Heinemann Medical. 1989;125-62.

Blaylock WK, Moore CA, Linberg JV. Anterior ethmoid anatomy facilitates dacryocystorhinostomy. Archives of ophthalmology. 1990;108(12):1774-7.

Welham RA, Henderson PH. Results of dacryocystorhinostomy analysis of causes for failure. Transactions of the ophthalmological societies of the United Kingdom. 1972;93:601-9.

Allen KM, Berlin AJ, Levine HL. Intranasal Endoscopie Analysis of Dacrocystorhinostomy Failure. Ophthalmic Plastic Reconstructive Surg. 1988;4(3):143-6.

Orcutt JC, Hillel A, Weymuller EA. Endoscopic repair of failed dacryocystorhinostomy. Ophthalmic Plast Reconstructr Surg. 1990;6:197-202.

Patrinely JR, Anderson RL. A review of lacrimal drainage surgery. Ophthalmic Plast Reconstructr Surg. 1986;2:97-109.

Waite DW, Whitted HB, Shun-Shin GA. Technical note: computed tomographic dacryocystography. Br J Radiol. 1993;6:711-4.

Dave TV, Mohammed FA, Ali MJ, Naik MN. Etiologic analysis of 100 anatomically failed dacryocystorhinostomies. Clinic Ophthalmol (Auckland, NZ). 2016;10:1419.

Linberg JV, Anderson RL, Bumsted RM, Barreras R. Study of intranasal ostium external dacryocystorhinostomy. Archives Ophthalmol. 1982;100(11):1758-62.

Yazici B, Yazici Z. Final nasolacrimal ostium after external dacryocystorhinostomy. Archives Ophthalmol. 2003;121(1):76-80.

Roper-Hall MJ. Stallard’s Eye Surgery, 7th ed. London and Boston: Butterworth-Heinemann Medical. 1989;125-62.

Yarmohammadi ME, Ghasemi H, Jafari F, Izadi P, Nadoushan MJ, Chin NS. Teamwork endoscopic endonasal surgery in failed external dacryocystorhinostomy. J ophthal vision Res. 2016;11(3):282.

Kushwaha RN, Rastogi R, Gupta RC, Gupta P, Kumar S. Profile of ocular trauma in tertiary care centre. Journal of Evolution of Medical and Dental Sciences. 2013;2(27):4903-15.

Eldesoky S, Farouk H, Moustafa AN, El-noueam K, Elsabaa A. The role of multi-detector CT dacryocystography in the assessment of naso-lacrimal duct obstruction. Egy J Radiol Nuclear Medic. 2012;43(3):397-405.

Elmorsy SM, Fayk HM. Nasal endoscopic assessment of failure after external dacryocystorhinostomy. Orbit. 2010;29(4):197-201.

Mauriello Jr JA, Vahedra V, Fleckner M, Shah C. Correlation of orbital computed tomographic findings with office probing and irrigation in 17 patients after successful and failed dacryocystorhinostomy. Ophthalmic Plastic Reconstructive Surg. 1999;15(2):116-20.

Manfrè L, de Maria M, Todaro E, Mangiameli A, Ponte F, Lagalla R. MR dacryocystography: comparison with dacryocystography and CT dacryocystography. Ame J Neuroradiol. 2000;21(6):1145-50.

Helies P, Cosnard G, Pharaboz C, Maille M, Maurin JF. Dacryocystography using CT and MRI. Comparative study apropos of 13 clinical cases. J Fr Ophtalmol. 1995;18:763-70.