Correlation between nasal mucosal thickness around the lacrimal sac fossa and surgical outcomes in endonasal dacryocystorhinostomy

다국어 초록 (Multilingual Abstract)

Objectives: To identify the relationship between surgical success rate and preoperative nasal mucosal thickness around the lacrimal sac fossa, as measured using computed tomography.
Methods: We reviewed 33 eyes from 27 patients who underwent endoscopic dacryocystorhinostomy after diagnosis of primary nasolacrimal duct obstruction and who were followed-up with for at least six months between 2011 and 2014. We measured preoperative nasal mucosal thickness around the bony lacrimal sac fossa using computed tomography and analyzed patient measurements after classifying them into three groups: the successfully operated group, the failed operation group, and the non-operated group.
Results: Surgery failed in six of the 33 eyes because of a granuloma at the osteotomy site and synechial formation of the nasal mucosa. The failed-surgery group showed a clinically significantly greater decrease in nasal mucosal thickness at the rearward lacrimal sac fossa compared with the successful-surgery group.
However, nasal mucosal thickness of fellow eyes (i.e., non-operated eyes) was not significantly different between the two groups, and the location of the uncinate process did not appear to influence mucosal thickness.
In the failed group, posteriorly located mucosal thickness of operated eye fossa was thinner than that of the non-operated eyes, but not significantly so.
Conclusions: Our results from this quantitative anatomical study suggest that nasal mucosal thickness is a predictor of endoscopic dacryocystorhinostomy results.

참고문헌 (Reference)

1 Watelet JB, "Wound healing of the nasal and paranasal mucosa : a review" 16 : 77-84, 2002

2 Woog JJ, "The incidence of symptomatic acquired lacrimal outflow obstruction among residents of Olmsted County, Minnesota, 1976-2000 (an American Ophthalmological Society thesis)" 105 : 649-666, 2007

3 McCormick A, "The diameter of the nasolacrimal canal measured by computed tomography : gender and racial differences" 37 : 357-361, 2009

4 Sarode, D., "The benefit of silicone stents in primary endonasal dacryocystorhinostomy: a systematic review and meta-analysis" 42 : 307-314, 2017

5 Fayet B, "Systematic unciformectomy for a standardized endonasal dacryocystorhinostomy" 109 : 530-536, 2002

6 Jung, S.K, "Surgical outcomes of endoscopic dacryocystorhinostomy: analysis of 1083 consecutive cases" 50 : 466-470, 2015

7 Fayet B, "Surgical anatomy of the lacrimal fossa a prospective computed tomodensitometry scan analysis" 112 : 1119-1128, 2005

8 Yang JW, "Success rate and complications of endonasal dacryocystorhinostomy with unciformectomy" 250 : 1509-1513, 2012

9 Smirnov G, "Strong expression of HSP47 in metaplastic nasal mucosa may predict a poor outcome after primary endoscopic dacryocystorhinostomy:a prospective study" 89 : e132-e136, 2011

10 Kostis, W.J., "Small pulmonary nodules: reproducibility of three-dimensional volumetric measurement and estimation of time to follow-up CT" 231 : 446-452, 2004

11 Wilhelm DL, "Regeneration of tracheal epithelium" 65 : 543-550, 1953

12 Hartikainen J, "Prospective randomized comparison of endonasal endoscopic dacryocystorhinostomy and external dacryocystorhinostomy" 108 : 1861-1866, 1998

13 Kim, S.Y., "No thermal tool using methods in endoscopic dacryocystorhinostomy: no cautery, no drill, no illuminator, no more tears" 270 : 2677-2682, 2013

14 Häusler R, "Microsurgical endonasal dacryocystorhinostomy with long-term insertion of bicanalicular silicone tubes" 124 : 188-191, 1998

15 Onerci M, "Long-term results and reasons for failure of intranasal endoscopic dacryocystorhinostomy" 120 : 319-322, 2000

16 Dietrich C, "Long-term follow-up of patients with microscopic endonasal dacryocystorhinostomy" 17 : 57-61, 2003

17 Allen KM, "Intranasal endoscopic analysis of dacrocystorhinostomy failure" 4 : 143-145, 1988

18 Ali MJ, "Histopathology, Immunohistochemistry, and Electron Microscopic features of a Dacryocystorhinostomy Ostium Cicatrix" 32 : 333-336, 2016

19 Herzallah, I., "Endoscopic Dacryocystorhinostomy (DCR): a comparative study between powered and non-powered technique" 44 : 56-, 2015

20 Goldberg RA, "Endonasal dacryocystorhinostomy : is it really less successful?" 122 : 108-110, 2004

21 Jokinen K, "Endonasal dacryocystorhinostomy" 100 : 41-44, 1974

22 Ali MJ, "Electron microscopic features of nasal mucosa treated with topical and circumostial injection of mitomycin C : implications in dacryocystorhinostomy" 31 : 103-107, 2015

23 Ly TH, "Diagnostic criteria for atrophic rhinosinusitis" 122 : 747-753, 2009

24 Onerci M., "Dacryocystorhinostomy. Diagnosis and treatment of nasolacrimal canal obstructions" 40 : 49-65, 2002

25 Nussbaumer M, "Concomitant nasal procedures in endoscopic dacryocystorhinostomy" 118 : 267-269, 2004

26 Fayet B, "Complications of standardized endonasal dacryocystorhinostomy with unciformectomy" 111 : 837-845, 2004

27 Mauriello JA Jr, "Clinicopathologic study of lacrimal sac and nasal mucosa in 44 patients with complete acquired nasolacrimal duct obstruction" 8 : 13-21, 1992

28 Woo KI, "Characteristics of intranasal structures for endonasal dacryocystorhinostomy in asians" 152 : 491-498, 2011

29 Wynn TA, "Cellular and molecular mechanisms of fibrosis" 214 : 199-210, 2008

30 Yong AM, "Assessment of bony nasolacrimal parameters among Asians" 30 : 322-327, 2014

31 Beshay, N., "Anatomical and subjective success rates of endonasal dacryocystorhinostomy over a seven-year period" 30 : 1458-1461, 2016

32 Bartley GB, "Acquired lacrimal drainage obstruction:an etiologic classification system, case reports, and a review of the literature. Part 3" 9 : 11-26, 1993

33 Leong SC, "A systematic review of outcomes after dacryocystorhinostomy in adults" 24 : 81-90, 2010

34 Leong SC, "A comparison of outcomes between nonlaser endoscopic endonasal and external dacryocystorhinostomy : single-center experience and a review of British trends" 31 : 32-37, 2010

35 Karim, R., "A comparison of external and endoscopic endonasal dacryocystorhinostomy for acquired nasolacrimal duct obstruction" 5 : 979-989, 2011

36 Heindl LM, "A clinicopathologic study of nasal mucosa in 350 patients with external dacryocystorhinostomy" 28 : 7-11, 2009

37 Gul A, "A Possible Cause of Nasolacrimal Duct Obstruction : Narrow Angle Between Inferior Turbinate and Upper Part of the Medial Wall of the Maxillary Sinus" 41 : 729-733, 2016