Dakryozystorhinostomie nach West in der interdisziplinären Behandlung von Tränenwegsstenosen

Abstract

Epiphora, which leads to blurry vision, is the leading symptom for intra- and/or postsaccal lacrimal duct stenosis. Due to the anatomy of the tear duct system, which lies between the fields of ophthalmology and otorhinolaryngology, and due to newly available techniques in interventional radiology to diagnose and treat patients with intra- and postsaccal lacrimal duct stenosis, various methods for diagnosis and treatment are available. We report the results of 107patients who underwent endonasal dacryocystorhinostomy (DCR) between 2005 and 2011. Prior to the DCR, dacryocystography was performed in 95 of the 107patients. In 68 of these 95cases, balloon dilatation was unsuccessful. Histological examination of 64patients showed chronic inflammation in 61patients, non-Hodgkin's lymphoma was diagnosed in 2patients and aspergilloma in1patient. Over a follow-up time of 6months to a maximum of 7years we revised 15 of 107patients, due to reocclusion after removal of the stent. None of these patients showed recurrence of epiphora. In comparison to transcutaneous DCR, endonasal DCR has certain benefits: it is less invasive, no visible scars occur because of the endonasal approach, and the function of the lacrimal pump remains uneffected. Furthermore, the possibility of co-treatment of endonasal pathologies during DCR exists. We observed no serious adverse events in our study group and the success rate was similar to other studies.