Beeinflusst die Resektion der mittleren "Turbinate" (Concha) die Erfolgsrate der endonasalen Dacryocystorhinostomie?

Abstract

BACKGROUND: To evaluate if the partial resection of the head of the middle turbinate increases a patency of the rhinostomy in the primary endonasal dacryocystorhinostomies (EDCR). METHODS: The definite evidence-based determination of the relative efficacy of partial turbinectomy on EDCR has not been established in the literature so far. The partial middle turbinate resection is performed during EDCRs in patients with the anteriorly enlarged middle turbinate or in whom the lacrimal sac projection on the lateral nasal wall is covered with the anteriorly located head of the middle turbinate to prevent rhinostomy closure. The data were retrospectivelly collected in 639 primary EDCRs performed in the patients over 16 years old in the period 1994–2008. Only the patients with subsaccal nasolacrimal duct obstructions were involved in the study (233 cases); the patients with canalicular obstructions and secondary surgical procedures (silicone intubation, Mitomycin C, ethmoidectomy, septoplasty) were excluded. The success rates of patients with the partial middle turbinate resection (group I) and without resection (group II) were compared one year after the surgery. RESULTS: The overall success rate was 217/233 (93.1%) in EDCRs with/without partial turbinate resections. In group I the success rate was 96/99 (96.9%), in group II 121/134 (90.3%). The differences between the results in groups I and II were statistically significant (p < 0.05). CONCLUSIONS: The partial middle turbinate resection significantly improves the success rate in the primary EDCRs.