Abstract
Between July 2014 and November 2015, we compared the curative effects and cost-effectiveness of two kinds of nasal endoscopic surgery for nasolacrimal duct obstruction (NLDO) in a single-centre, two-armed clinical trial with a 1-year follow-up. We included two groups: a recessive spherical headed silicone intubation (RSHSI) group and an endonasal dacryocystorhinostomy (En-DCR) group; both received nasal endoscopy. Patients were recruited from the Otorhinolaryngology and Ophthalmology departments. The main outcome measures were epiphora improvement (classified as cure, effective, or invalid), cost-effectiveness, visual analogue scale (VAS) intraoperative pain score, bleeding volume, operating time, hospitalisation time, total cost, and VAS postoperative epiphora score. No significant group difference was identified in postoperative epiphora VAS scores (P > 0.050) or success rate (P = 0.406). However, average VAS intraoperative pain score, operating time, bleeding volume, hospitalisation time and total cost in the RSHSI group were clearly lower to those in the En-DCR group (P = 0.000). In conclusion, RSHSI under nasal endoscopy can provide similar treatment outcomes to En-DCR. RSHSI has advantages including minimal invasiveness, reduced risk, shorter duration of surgery and hospitalisation, reduced intraoperative discomfort, and lower financial burden, which is more acceptable to patients. Thus, RSHSI may be the preferred option for NLDO.
Highlights
Between July 2014 and November 2015, we compared the curative effects and cost-effectiveness of two kinds of nasal endoscopic surgery for nasolacrimal duct obstruction (NLDO) in a single-centre, two-armed clinical trial with a 1-year follow-up
An adverse event occurred in the recessive spherical headed silicone intubation (RSHSI) group and four of these patients were lost to follow-up
Forty-three NLDO patients (50 eyes) recruited from the Department of Otorhinolaryngology and the Department of Ophthalmology were divided into two groups; there were no significant differences between the groups (Table 2)
Summary
Between July 2014 and November 2015, we compared the curative effects and cost-effectiveness of two kinds of nasal endoscopic surgery for nasolacrimal duct obstruction (NLDO) in a single-centre, two-armed clinical trial with a 1-year follow-up. Average VAS intraoperative pain score, operating time, bleeding volume, hospitalisation time and total cost in the RSHSI group were clearly lower to those in the En-DCR group (P = 0.000). With the development of endoscopy, endoscopic endonasal dacryocystorhinostomy (En-DCR) has become popular because of its minimal invasiveness, good visualisation, short operation and hospitalisation durations, limited bleeding, and high success rate. Many surgeons prefer to use recessive spherical headed silicone intubation (RSHSI) for the treatment of nasolacrimal duct obstruction (NLDO). In this study—a joint project between otorhinolaryngologists and ophthalmologists—we investigated RSHSI performed under nasal endoscopy in terms of its intraoperative visualisation[1, 12,13,14], lower risk of complications, and cost-effectiveness. We investigated the efficacy and cost-effectiveness of RSHSI
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