Rubber Tube versus Silicone Tube at the Osteotomy Site in External Dacryocystorhinostomy

Abstract

Background: In external dacryocystorhinostomy a large bony window is created in the lateral nasal wall and a mucosal anastomosis is created between the lacrimal sac and the nasal cavity. The success of the operation depends on the surgical anastomosis remains patent and converting to a wide enough epithelial-lined passage.Objective: To compare the efficacy of using rubber versus silicone tubes at the osteotomy of DacryocystorhinostomyDesign: Prospective, randomized, hospital-based study.Subjects and Methods: 46 patients diagnosed with primary acquired nasolacrimal duct obstruction were assigned randomly to rubber, silicone or control group. The surgical procedures in the three groups were the same except that in patients of rubber and silicone groups, rubber or silicone tubes were placed at osteotomy opening and removed after 3 months. Transnasal endoscopic findings were recorded at the completion of surgery and at 3 months, 6 months and 9 monthes after surgery for the 3 groups. A computer aided digitizer was used to calculate the surface area of the osteotomy site.Results: After removal of their tubes, 3 patients in the rubber group had recurrent epiphora (78.0% success), one patient in silicone group (92.86% success) and 4 patients in control group (77.8% success). The average final surface area of the osteotomy opening of patients with rubber group at the end of follow-up was (9.85 mm2) in the silicone group was (17.47 mm2), whereas in the control group was (8.56 mm2).Conclusion: Silicone tube is better than rubber one in maintaining effective larger osteotomy after Dacryocystorhinostomy. This can improve the long-term success of the operation.