First results of endonasal balloon dacryoplasty use in recurrence after dacryocystorhinostomy

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Abstract

Background. In recurrent dacryocystitis after dacryocystorhinostomy, a re-operation is indicated. In recent years, some publications appeared concerning endonasal dacryoplasty using 9 mm-balloon in treatment of patients with recurrent dacryocystitis.

Purpose – to evaluate the possibility of using endonasal balloon dacryoplasty in recurrence after dacryocystorhinostomy.

Materials and methods. Into the study, 6 patients (6 cases) were included who underwent endonasal endoscopic dacryocystorhinostomy for dacryocystitis 1-3 years before. In all patients, evaluation of Munk’s scores for epiphora, optical coherence tomography (OCT) based lacrimal meniscometry, dye disappearance test, lacrimal drainage system syringing and probing of its horizontal part, nasal endoscopy, multispiral computed tomography of lacrimal drainage system with contrast enhancement. In all patients, endonasal dacryoplasty using a balloon with 6 mm diameter was carried out. The follow-up period after surgery was 6 months.

Results. In 4 patients, “recovery” was achieved, in 1 patient “improvement“ was obtained, in 1 patient there was dacryostoma cicatrization.

Conclusion. Preliminary results received in this study of the balloon dacryoplasty performed in 6 patients afford ground to consider it possible to use this method in patients with dacryocystitis recurrence after dacryocystorhinostomy. The matter of the prospects when using this method may be solved after further research aimed to increase the number of clinical observations to enhance the possibility of adequate statistical processing of obtained results, to extend the postoperative follow-up period, to develop the indications for this procedure, and to investigate the necessity in additional manipulations improving the effectiveness of endonasal balloon dacryoplasty.

About the authors

Eugeniya L. At’kova

Federal State Budgetary Institution of Science “Research Institute of Eye Diseases”

Email: evg.atkova@mail.ru
ORCID iD: 0000-0001-9875-6217
SPIN-code: 1186-4060

MD, Doctor of Medical Science, Head of the Department of Pathology of the Lacrimal Apparatus

Russian Federation, Moscow

Nikolay N. Krakhovetskiy

Federal State Budgetary Institution of Science “Research Institute of Eye Diseases”

Email: n.krahovetskiy@niigb.ru
ORCID iD: 0000-0002-3247-8418
SPIN-code: 8112-2018

MD, PhD, Assistant Professor, Department of Pathology of the Lacrimal Apparatus

Russian Federation, Moscow

Oleg V. Zhukov

Federal State Budgetary Institution of Science “Research Institute of Eye Diseases”

Author for correspondence.
Email: Sparrowhawk92@mail.ru
ORCID iD: 0000-0002-2338-9085
SPIN-code: 1707-3150

Graduate Student, Department of Pathology of the Lacrimal Apparatus

Russian Federation, Moscow

References

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  2. Жуков О.В., Атькова Е.Л., Краховецкий Н.Н. Лечение пациентов с рецидивом дакриоцистита после выполненной ранее дакриоцисториностомии // Офтальмологические ведомости. – 2019. – Т. 12. – № 4. – С. 67–72. [Zhukov OV, At’kova EL, Krakhovetskiy NN. Balloon dacryoplasty in the treatment of recurrent dacryocystitis. Ophthalmology Journal. 2019;12(4):67-72. (In Russ.)]. https://doi.org/10.17816/OV17696.
  3. Mueller SK, Freitag SK, Lefebvre DR, et al. Revision eDCR using a superior pedicled mucosal flap. Orbit. 2019;38(1):1-6. https://doi.org/10.1080/01676830.2018.1444062.
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  5. Silbert DI, Matta NS. Outcomes of 9 mm balloon-assisted endoscopic dacryocystorhinostomy: retrospective review of 97 cases. Orbit. 2010;29(3):131-4. https://doi.org/10.3109/01676830.2010.480924.
  6. Mishra AK, Nilakantan A, Mishra S, Mallick A. Comparison of balloon dacryocystorhinostomy with conventional endonasal endoscopic dacryocystorhinostomy for relief of acquired distal nasolacrimal drainage obstruction and its impact on quality of life: a prospective, randomized, controlled study. Med J Armed Forces India. 2018;74(3):255-263. https://doi.org/10.1016/j.mjafi.2017.08.010.
  7. Kumar S, Mishra AK, Sethi A, et al. Comparing outcomes of the standard technique of endoscopic DCR with its modifications: a retrospective analysis. Otolaryngol Head Neck Surg. 2019;160(2):347-354. https://doi.org/10.1177/0194599818813123.
  8. Атькова Е.Л., Федоров А.А., Ярцев В.Д., Роот А.О. Разработка оптимального способа проведения баллонной дакриопластики // Вестник офтальмологии. – 2015. – T. 131. – № 2. – C. 99–104. [At’kova EL, Fedorov AA, Yartsev VD, Root AO. Developing the optimal protocol for balloon dacryoplasty. Vestnik Oftalmologii. 2015;131(2):99-104. (In Russ.)]. https://doi.org/10.17116/oftalma2015131299-104.
  9. Атькова Е.Л., Ярцев В.Д., Краховецкий Н.Н., Роот А.О. Сравнительный анализ результатов баллонной дакриопластики при стенозах вертикального отдела слезоотводящих путей различной локализации // Вестник офтальмологии. – 2015. – T. 131. – № 4. – С. 66–73. [At’kova EL, Yartsev VD, Krakhovetskiy NN, Root AO. Comparative analysis of the results of balloon dacryoplasty for stenoses at different levels of the vertical portion of lacrimal pathways. Vestnik Oftalmologii. 2015;131(4):66-73. (In Russ.)]. https://doi.org/10.17116/oftalma2015131466-72.

Supplementary files

Supplementary Files
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1. JATS XML
2. Fig. 1. Photo of a balloon catheter of 6 mm diameter in inflated state (Acclaren Inc., USA): a – active part of the balloon catheter; b – Luer-lock for connection with the indeflator

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3. Fig. 2. Endoscopic view of scar tissue in the area of dacryostoma (left nasal cavity). The ostium was probed with Bowman probe

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4. Fig. 3. The appearance of a balloon catheter inserted through an irrigation cannula: a – balloon catheter; b – irrigation cannula

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5. Fig. 4. Endoscopic view of a left nasal cavity with an inserted and inflated balloon catheter

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6. Fig. 5. Endoscopic view of dilated dacryostoma (left nasal cavity) following balloon dacryoplasty. The ostium was probed with Bowman probe

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7. Fig. 6. Multispiral computed tomography of lacrimal drainage system with contrast enhancement: а – left lacrimal sac filled with contrast; b – borders of the bone window

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8. Fig. 7. Endoscopic view of a dacryocystorhinostomy-ostium (left nasal cavity) 6 months after endonasal balloon dacryoplasty; arrow indicates the lumen of the dacryocystorhinostomy-ostium

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Copyright (c) 2021 At’kova E.L., Krakhovetskiy N.N., Zhukov O.V.

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This work is licensed under a Creative Commons Attribution 4.0 International License.
 


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