Endoscopic revision of external dacryocystorhinostomy.

OBJECTIVES: To observe the benefit of endoscopic surgery for the treatment of lacrimal duct obstruction in revisional surgeries after external dacryocystorhinostomy. STUDY DESIGN AND SETTING: Retrospective nonrandomized study. Eleven cases of recurrent lacrimal duct obstruction after external dacryocystorhinostomy were submitted to endoscopic dacryocystorhinostomy. RESULTS: The rate of success after revisional surgery was 90.9%. The major causes of failure of the external approach were the presence of granulation tissue, septal deviations and synechiae near the opening of the fistula, inadequate removal of the bony wall adjuvant the lacrimal sac, technical error in the localization of the lacrimal sac, and excessive perioperative bleeding that impaired the surgical field. CONCLUSION: Endoscopic dacryocystorhinostomy in revisional cases proved to be a safe technique of low morbidity, permitting effective resolution of the lacrimal obstructions. SIGNIFICANCE: Endoscopic surgery allows greater visibility of the lacrimal sac and its neighbor anatomic alterations and leads to better results.

[Endoscopic nasal dacryocystorhinostomy: results and advantages over the external approach]. / Dacriocistorrinostomia endoscópica nasal: resultados e vantagens sobre a abordagem externa.

UNLABELLED: Dacryocystorhinostomy (DCR) is a procedure used to create a lachrymal drainage pathway into the nasal cavity in order to reestablish the permanent drainage of a previously obstructed excretory system. AIM: to report our results obtained with endoscopic DCR technique, describing its advantages and disadvantages STUDY DESIGN: Historic cohort. MATERIAL AND METHOD: we retrospectively analyzed thirty-two dacryocystorhinostomies performed at the Otorhinolaryngology Discipline from March 2002 to January 2004 on patients with post-lachrymal sac obstruction confirmed by dacryocystorhinography (DCG). In all cases, the patients were submitted to probing with Crawford probe. RESULTS: surgery was bilateral in ten of the twenty-two analyzed patients, totaling thirty-two procedures, twenty-nine of which were primary surgeries and three revision procedures after unsuccessful external DCR. Our success rate was 79.12%. CONCLUSIONS: endoscopic DCR proved to be a safe and low morbidity technique, which also avoids facial scars and maintains the mechanism of the lachrymal pump, with results similar to those obtained with external DCR.

Dacriocistorrinostomia endoscópica nasal: resultados e vantagens sobre a abordagem externa

A Dacriocistorrinostomia (DCR) consiste em criar uma via de drenagem lacrimal para a cavidade nasal, tendo como objetivo restabelecer a drenagem permanente deste sistema excretor previamente obstruído. OBJETIVO: Relatar nossos resultados com a técnica de DCR endoscópica, expondo vantagens e desvantagens em relação à técnica externa. FORMA DE ESTUDO: Coorte histórica. MATERIAL E MÉTODO: Foram analisadas retrospectivamente trinta e duas dacriocistorrinostomias realizadas pela Disciplina de Otorrinolaringologia de março de 2002 a janeiro de 2004 em pacientes com obstrução pós-saco lacrimal comprovada por dacriocistografia (DCG). Todos foram submetidos à sondagem com sonda de Crawford. RESULTADOS: Dos vinte e dois pacientes analisados, a cirurgia foi bilateral em dez totalizando trinta e dois procedimentos, sendo vinte e nove cirurgias primárias e três casos revisionais de insucessos com DCR externa. Nossa taxa de sucesso foi de 79,12 por cento. CONCLUSÕES: A DCR endoscópica mostrou ser uma técnica segura, com baixa morbidade, além de evitar cicatrizes faciais e manter o mecanismo de bomba lacrimal, com resultados semelhantes à DCR externa.

Laceraçöes dos canalículos lacrimais / Lacrimal canalicular lacerations

Este artigo no relato de 21 anos de laceraçöes de canalículos lacrimais, no período de 1984 a 1990 e a nossa experiência nas diferentes técnicas cirúrgicas de reconstruçäo