PREVALENCE OF ENDONASAL PATHOLOGY IN PATIENTS WITH CHRONIC DACRYOCYSTITIS AND PECULIARITIES OF SURGICAL TREATMENT

Abstract

Purpose – to study the prevalence of endonasal pathology in patients with chronicdacryocystitis (CD) and to justify the expediency of simultaneous operations in suchpatients.Material and methods. The study included 109 patients with CD, who were examinedand operated on in 2004-2014 at the Department of Otorhinolaryngology Faculty ofInternship and Postgraduate Education "Donetsk National Medical University of theMinistry of Health of Ukraine". Examination of patients included consultation with anophthalmologist, lavage of the lacrimal ducts, endoscopy of the nasal cavity, computedtomography. All patients underwent tearing by performing endonasal endoscopicdacryocystorhinostomy (EEDCR).Results. Endonasal pathology was detected in 85.3% of patients: curvature of the nasalseptum - in 71.6% of patients, hypertrophy of the inferior turbinate - in 59.6%, bulloushypertrophy of the middle turbinate - in 5.5%, hypertrophy of the uncinate process- in 6.4%, hyperpneumatization of Agger nasi cells - in 14.7% of patients. The mostcommon combination was curvature of the nasal septum and hypertrophy of the inferiorturbinates - in 56.0% of cases. Inflammatory pathology in the paranasal sinuses wasin 38.5% of cases: ethmoiditis - in 26.6% of patients, maxillary sinusitis - in 13.8%,sphenoiditis - in 1.8% of patients. In 94.6% of patients, the correction of intranasalpathology was performed simultaneously with EEDCR. In 6.4% of these patients therewere complications - nosebleeding after removal of tampons. Simultaneous operationsdid not significantly increase the percentage and variants of complications comparedwith isolated endonasal operations.Conclusion. The vast majority of patients with chronic dacryocystitis have pathologyof the nasal cavity and paranasal sinuses, which may contribute to the developmentof dacryocystitis and relapse of the disease after operation. Surgical correction ofconcomitant endonasal pathology in patients with chronic dacryocystitis should beperformed simultaneously with endonasal endoscopic dacryocystorhinostomy.